• How long will the entire process take?
The program typically takes about 6 months to reach graduation and maintenance dosing. If you would prefer to do once a day dosing, it will take around 10 months to reach graduation. The first day procedure in the office will take about 6 hours. Then you will have weekly or biweekly appointments that will take about 1 ½ hours.
• Should routine medications be stopped before the first day of OIT procedure?
No. You should continue to take any routine medications throughout OIT. Keeping any chronic conditions controlled such as asthma, allergies, eczema will help reduce problems during OIT.
• How often can the dose be increased?
For twice a day dosing, after 6 days you are eligible for a dose increase appointment. For once a day dosing you are eligible for a dose increase after 13 days. All dose increases must be done in our office.
• What time of day should home doses be given?
You have a 9-15-hour dosing window for twice a day dosing. You want to give the dose at least 9 hours apart, but no longer than 15 hours. For once a day dosing, you have a 22-26-hour window.
• When dosing twice daily at home, morning and night, what should be done if the next
appointment for dose increase is midday?
Midday appointments should be avoided so that the dosing schedule will not be disrupted. Try to schedule dose increase appointments for early morning or late afternoon so that doses may continue to be given at least 9 hours apart.
• How long should my child stay awake after the evening dose?
Children should be observed for at least one hour after the dose is given. They should not be allowed to sleep during this time.
• What about home dosing on the day of the office visit for dose increase?
There should be at least nine hours and no more than 15 hours between doses, we will assist you in scheduling your appointments so it is manageable with your home dosing schedule. NEVER increase the dose at home, doing this will result in discharge from the program.
• If there is a reaction at home, what should I do?
We will go over what to do during any type of reaction at your first day appointment. You will be given written instructions on how to treat reactions and we have an on-call nurse and doctor 24/7.
• What if we are flying when the dose is due?
Do not administer the dose less than one hour before boarding and do not administer the dose while flying. If there are scheduling conflicts while traveling, please let us know so we can give you special dosing instructions. A letter explaining the procedure and need for food solutions for the Transportation Safety Authority is available on request.
• Does the food solution need refrigeration?
There are no preservatives in the food solution. It MUST be kept cold.
• What if I need additional doses?
Call as soon as you know you need more solution or doses. If this is done during regular office hours, there will be no charge. If a staff member needs to come in at night, on a weekend or holiday, there will be an additional charge of $50. This fee cannot be charged to your insurance.
• What if my child is sick and can’t take the doses on schedule?
If your child is sick call us before giving any doses. Illness can increase the risk of having a reaction. Please call our office if you have fever, asthma flare or other illness.
• What about masking the taste of the food?
Taste is personal; experiment. Small volumes could be mixed with a semi-solid food such as apple sauce or pudding, but it is important that the entire dose of oral immunotherapy mixture be taken. If the total amount gets too large, it will be hard to get it all down. If you are having a difficult time with masking the flavor, ask our staff for recommendations.
• What is the goal of this process?
The number one goal is safety: to avoid anaphylaxis if the allergenic food is accidentally ingested. The freedom that comes from OIT is being able to eat foods without reading labels or worrying about if it is cross contaminated.
• What is the follow up schedule when a full portion of the food is being eaten?
When the full dose has been reached, there should be follow up at one month and then every three-six month after that. We will repeat labs at the one month follow up and then yearly.
• When dosing is reduced to once a day, is the time of day important?
Time of day is not important but the amount of time between doses is important. We have achieved a delicate balance that depends on a certain amount of the allergenic protein being in the system at all times. You should try to give the once a day dose around the same time every day (24 plus or minus two hours).
• Does my child need to avoid exercise during the oral immunotherapy process?
Exercise should be avoided for at least two hours after dosing and doses should not be given immediately following exercise. Exercise around the time of dosing increases the chance of a reaction. Exercise restriction applies to escalation and maintenance dosing.
• What is maintenance dosing?
Anytime you desensitize someone to something you must continue to consume the food so you will remain desensitized. For example, after graduating from Peanut OIT, you will eat a minimum of 8 peanuts once a day to remain desensitized.
• Is maintenance dosing for the rest of your life?
Until we have further research and data to prove otherwise, you could potentially have to do maintenance dosing for the rest of your life. New research is always being published and we will keep you up to date with the latest published data.
• What is the first step to starting OIT?
Once your doctor has recommended OIT for you, call to schedule an OIT consult. At the OIT consult we will go into more detail, discuss the consents, answer all your questions, give you the financial estimate and get you on the schedule for your first OIT visit if you are interested.