*NEW* Food Allergy Treatments
At our new Food Allergy Center, we’re dedicated to helping patients live more confidently with food allergies.
We now offer three advanced treatment options all carefully personalized to raise your reaction threshold, lower the risk of severe reactions from accidental exposure, and help make daily life easier.
SLIT (Sublingual Immunotherapy) for Food Allergies
SLIT for food allergies, consists of a protocol where very small, gradually increasing doses of the allergen are placed under the tongue (sublingually) to help the immune system become less reactive over time.
How SLIT Works for Food Allergies:
- A liquid form of the allergen (like peanut, milk, or egg proteins) is administered under the tongue.
- The allergen is absorbed through the blood vessels in the mouth, where over time the immune cells learn to tolerate it.
- The allergy drops are taken daily at home, following a careful dose-escalation plan under medical supervision with your allergist.
Goal of SLIT:
To desensitize the immune system to your food allergen, that is, teaches the body so that accidental exposures to the food allergen do not cause a severe allergic reaction (like anaphylaxis). It’s not a cure, but it can significantly reduce sensitivity by increasing the amount of allergen needed to cause a reaction.
Benefits and Considerations
- No needles or injections
- Available for most patients of age 5 and up (eligibility individualized by the Allergist).
- Safe – very low risk of serious reactions to the drops
- At-home personalized treatment (convenient!)
- Effective
- Reducing reliance on allergy medications
- Access to a physician in-person or via telemedicine
SLIT for food allergy is not currently FDA-approved, but it is an emerging, evidence-based option that can increase the amount of food a person can tolerate before reacting in selected patients.
If you are a candidate for drops, you will have access to a physician in-person, via telemedicine, or through an after hours phone line.
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Oral Immunotherapy (OIT)
The American College of Allergy, Asthma & Immunology (ACAAI) endorses oral immunotherapy (OIT) as a treatment option for IgE-mediated food allergies. Oral Immunotherapy is a treatment designed to desensitize the immune system of patients with food allergies by having them eat small, increasing amounts of the allergenic food and offers protection against accidental exposure.
Video: How Oral Immunotherapy (OIT) Works
Watch how oral immunotherapy for food allergies works at our Food Allergy Center in South Florida. This video walks through the OIT process step by step, from the first supervised dose to maintenance, and three families describe what the journey was like for their children. OIT is not a cure and is not right for every child, but for some families it may help lower the risk from accidental exposure. To find out whether OIT may be an option for your child, speak with one of our board certified allergists.
What Happens in OIT?
The protocol has three phases:
- Initial Dosing visit:
During the first visit, you will start with consuming 4 very low doses of your food allergen, separated by 30 minutes in between doses. This is the longest visit– taking approximately 4 hours. - Build-Up Phase (weekly/biweekly, in clinic):
Every month, you will return for an updosing visit– where higher doses are introduced and monitored. - Maintenance Phase (daily, at home):
The patient continues to take the highest tolerated dose daily at home to maintain desensitization, that is to keep the immune system trained to tolerate the allergen.
Goal of OIT:
To raise the threshold of reactivity, so that if the person accidentally eats a small amount of the allergen, it won’t trigger a severe allergic reaction (like anaphylaxis). In some cases, it may also allow some people to eat the food freely.
Who Is It For?
- We offer OIT for certain other foods such as tree nuts, milk, and egg. These uses are off-label but supported by growing clinical evidence.
- OIT can reduce the risk of life-threatening reactions and even allow some patients to freely eat the allergen.
Benefits and considerations:
- OIT can significantly increase the amount of allergen a patient can tolerate and reduce the risk of life-threatening reactions from accidental exposures.
- Some patients may eventually be able to include the food in their diet under guidance.
- Supervision: All dose increases must be conducted in a medical setting due to the risk of allergic reactions, including anaphylaxis.
- Activity restrictions: Patients must avoid vigorous physical activity, hot showers, and hot baths for two hours after each dose, as these activities can increase the risk of a reaction.
- Weighing risk vs. benefit: OIT requires a long-term, high-commitment effort with real-life constraints, and the risk of allergic reactions must be carefully weighed against the potential benefits.
- Not a cure: OIT is not a cure and does not guarantee a permanent change. Patients must continue to carry epinephrine and read food labels for allergens while undergoing OIT.
Xolair (omalizumab)
Xolair is an FDA-approved biologic medication that has been in use for the last 20 years. Initially it was approved for the treatment of severe asthma, and later was approved to treat other conditions such as chronic urticaria (hives) and nasal polyps. In 2024, it was approved for the treatment of food allergy in patients aged 1 and up.
How does it work?
- Xolair helps to reduce the risk of a severe allergic reaction from accidental exposure to a food allergen. This is wonderful to help alleviate anxiety, and offers protection against cross-contamination.
- Xolair is an FDA-approved biologic injection for IgE-mediated food allergies in adults and children ages 1 and older.
- Injections are administered in our office every 2-4 weeks, depending on a patient’s weight and total IgE in the blood.
Goal of Xolair:
To decrease the risk of anaphylaxis from accidental exposure to food allergens. This is done by increasing the “threshold of reactivity,” meaning more of the allergen will need to be eaten to cause anaphylaxis or allergic reaction.
Benefits and Considerations
- May be preferred in some patients with multiple food allergies
- May be preferred for patients with significant anxiety surrounding eating their food allergen
- This treatment is an injection – must be comfortable with needles
- Must be approved through insurance
- Less risk of anaphylaxis or allergic reactions than OIT
- Not a cure– the patient must still avoid food allergens and carry epinephrine at all times
Are you a candidate for one of these three food allergy treatments? Make an appointment today with our allergy experts to find out!
Glossary Definitions
Oral Immunotherapy
You might benefit from immunotherapy to help build up a tolerance to your offending triggers. Sublingual Immunotherapy (also known as Allergy Tablets) or Liquid Drops Formulations are offered to some patients who suffer from allergies to short ragweed and some grass pollen. The tablets or drops will increase tolerance to the pollen and reduce symptoms over time. For continued effectiveness, treatment may be needed for three years or longer.
Sublingual Immunotherapy
Sublingual Immunotherapy, commonly known as Allergy drops, are a method of treating allergies by placing drops underneath the tongue: a small dose of an allergen being introduced into the patient allows the body to build immunity over time. A dropper of antigens is placed under the tongue daily until the patient doesn’t experience any reactions anymore. They can be used for a wide variety of allergies in most patients from infants to adults.
General Questions About the Food Allergy Center
The Food Allergy Center is a specialized division of Florida Center fFor Allergy & Asthma Care (FCAAC) dedicated to the diagnosis, evaluation, and advanced treatment of food allergies. Unlike traditional food allergy management, which focuses primarily on strict avoidance and carrying emergency epinephrine, our Food Allergy Center offers three evidence-based treatment options designed to reduce your sensitivity and lower the risk of severe reactions from accidental exposure.
The Food Allergy Center is currently available at three FCAAC locations: Aventura (Miami-Dade), Palmetto Bay (Miami-Dade), and Plantation (Broward). We anticipate expanding the program to additional locations across our 19-office network in the near future.
We accept patients ages 1 and up, from toddlers to adults. Each treatment option has its own age and eligibility criteria, which your board-certified allergist will review with you during your consultation.
Your first visit is a thorough consultation with one of our board-certified allergists. We will review your allergy history, prior reactions, current medications, and any existing test results. If needed, we may perform allergy skin prick testing or order specific IgE blood tests to confirm your diagnosis and guide the recommendation for SLIT, OIT, or Xolair.
A referral is not required to schedule a consultation. However, some insurance plans require one for coverage purposes — we recommend confirming with your insurer before your visit. Referring providers can submit referrals through our online portal at florida-allergy.com.
No. If you have experienced a suspected food allergic reaction and have not yet been formally diagnosed, our allergists can evaluate and test you at your first visit.
We treat a wide range of IgE-mediated food allergies, including peanut, tree nuts (such as cashew, walnut, and hazelnut), milk, egg, and other foods depending on the treatment. Your allergist will discuss which allergens are appropriate for treatment based on your individual profile.
Yes. Our Food Allergy Center operates within FCAAC’s broader allergy and asthma practice. Patients with asthma, environmental allergies, chronic urticaria, or other conditions will continue to receive coordinated care — our clinicians monitor your overall allergic health at every visit.
About SLIT (Sublingual Immunotherapy Drops)
Sublingual Immunotherapy (SLIT) for food allergies involves placing very small, gradually increasing doses of a liquid allergen extract under your tongue each day. Over time, this trains your immune system to become less reactive to that food allergen.
SLIT requires no needles or injections. The drops are placed under the tongue at home each day, making it a highly convenient option — no weekly office visits required for dosing. You will still see your allergist periodically to monitor progress.
SLIT for food allergy is not currently FDA-approved. However, it is an emerging, evidence-based treatment supported by clinical research. Your allergist will discuss the benefits and limitations in full during your consultation.
SLIT is generally available to patients ages 5 and up, though eligibility is individualized by your allergist. It is often a preferred option for patients who are not comfortable with the level of commitment required by OIT, those with higher anxiety around their allergen, or younger children for whom OIT may be more complex.
SLIT can be used for many of the same food allergens we treat with OIT, including peanut, tree nuts, milk, egg, and others. Multi-food SLIT — treating more than one allergen at the same time — may also be an option.
The goal is desensitization: to train your immune system so that accidental exposure to the allergen does not cause a severe reaction. SLIT typically increases the amount of allergen needed to trigger a reaction. It is not a cure, and patients should continue to carry epinephrine and avoid their allergens throughout treatment.
Unlike OIT, SLIT does not require a rest period before or after taking a dose, which adds to its convenience for active patients and busy families.
SLIT is a long-term commitment. Patients typically take drops daily at home and return to our office periodically — usually annually in the early years — to assess progress through an oral food challenge. Your allergist will outline an individualized treatment timeline.
Yes. Patients on SLIT have access to an FCAAC physician in person, via telemedicine, or through an after-hours phone line.
Sublingual immunotherapy is very safe, for both adults and children. Patients take the drops in the convenience of their own homes instead of going to a doctor’s office every week for shots. The World Health Organization (WHO) has endorsed sublingual immunotherapy as a viable alternative to injection immunotherapy.
Many published scientific studies have shown that sublingual immunotherapy significantly reduces allergy symptoms.
It is not recommended for pregnant women to start taking allergy drops. However, if a patient is already taking sublingual immunotherapy drops and becomes pregnant, they can continue SLIT at a stable dose throughout pregnancy.
Yes, it is safe to fly while taking sublingual immunotherapy drops. Ask your doctor for a letter to carry the drops in the cabin.
Yes, children from the age of 7 can get sublingual immunotherapy (SLIT).
About Oral Immunotherapy (OIT)
Oral Immunotherapy (OIT) is a treatment endorsed by the American College of Allergy, Asthma & Immunology (ACAAI) in which patients consume small, carefully escalating doses of an allergenic food under medical supervision. The goal is to raise the threshold of reactivity — so that if you accidentally eat a small amount of the allergen, your body will not trigger a severe allergic reaction.
We offer OIT for peanuts, tree nuts, milk, egg, and select other foods. Uses are off-label but supported by a strong and growing body of clinical evidence. Your allergist will review the evidence and options with you.
OIT has three phases:
- Initial Dosing Visit — You will consume four very small doses of your allergen, separated by 30-minute observation periods. This visit takes approximately 4 hours.
- Build-Up Phase — You return to the office roughly monthly for supervised dose increases (updosing visits).
- Maintenance Phase — Once you reach the highest tolerated dose, you continue taking it daily at home to keep the immune system trained.
The build-up phase typically takes 10–12 months, depending on how you respond to each dose increase. Your allergist will adjust the timeline based on your progress.
Yes, allergic reactions are possible during OIT — particularly during dose increases. All supervised dosing takes place in our office for this reason. Patients must continue to carry epinephrine at all times throughout treatment.
Yes. Patients must avoid vigorous physical activity, hot showers, and hot baths for two hours after each dose, as these can increase the risk of a reaction. Your allergist will review all restrictions in detail.
OIT is not a cure. It creates a state of desensitization — meaning you can tolerate more of the allergen than before — but this requires ongoing daily dosing at the maintenance level to sustain. Some patients may eventually be able to eat the food freely, though this outcome varies. You must continue to carry epinephrine and read food labels throughout treatment.
Missing doses can reduce your tolerance and increase the risk of a reaction when you resume. Always contact your FCAAC care team before resuming OIT if you have missed doses.
About Xolair® (Omalizumab)
Xolair (omalizumab) is an FDA-approved biologic medication that targets immunoglobulin E (IgE) — a key driver of allergic reactions. It has been used safely for more than 20 years in the treatment of severe asthma and chronic urticaria. In 2024, the FDA approved Xolair for the treatment of IgE-mediated food allergies in patients ages 1 and up.
Xolair works by binding to and blocking IgE in the bloodstream, which reduces the immune system’s ability to mount a severe allergic response. This increases the threshold of reactivity — meaning a larger quantity of the allergen is needed to cause a reaction. It significantly reduces the risk of anaphylaxis from accidental exposure.
Xolair is given as a subcutaneous (under-the-skin) injection in our office every 2 to 4 weeks. The frequency and dose are determined by your weight and total IgE level in the blood, measured before starting treatment.
No. Patients taking Xolair must continue to avoid their food allergens. Xolair reduces the risk of a reaction from accidental exposure — it does not eliminate the allergy or permit intentional consumption of the food.
Xolair’s protective effect is active only while you are receiving injections. Once treatment stops, IgE is no longer blocked and sensitivity returns. Your allergist will discuss the long-term plan with you.
Xolair may be the preferred option for patients who: have multiple food allergies, experience significant anxiety related to accidental exposure, or are not ideal candidates for the daily commitment of SLIT or OIT. It is approved starting at age 1, making it available to very young patients.
Xolair requires prior authorization from your insurance plan. Our team will work with you and your insurer to navigate the approval process before beginning treatment. Out-of-pocket costs vary by plan.
Xolair has a well-established safety profile developed over 20+ years of clinical use. As with any injectable medication, there is a small risk of allergic reaction at the injection site. All injections are administered in our office, where our team is equipped to monitor you. Do not receive Xolair if you are allergic to omalizumab.
Choosing the Right Treatment
The right treatment depends on your specific allergen(s), the severity of your allergy, your age, your lifestyle, and your goals. Your board-certified FCAAC allergist will evaluate all of these factors at your consultation and make a personalized recommendation. Some patients may be candidates for more than one option.
In some cases, yes. Xolair is sometimes used in combination with OIT to improve safety during the build-up phase, particularly in highly sensitive patients. Your allergist will determine whether combination therapy is appropriate for you.
Patients who have had difficulty completing OIT at another practice may still be candidates at FCAAC. We offer individualized protocols and, in appropriate cases, may consider Xolair to facilitate a safer OIT build-up. Please share your prior treatment history at your consultation.
If none of the three current treatment options is right for you at this time, your FCAAC allergist will still provide comprehensive food allergy management — including updated action plans, epinephrine prescription guidance, and monitoring. We will continue to evaluate your candidacy as your situation evolves and as new treatments become available.
Yes. All three options are available across a wide age range. SLIT is generally available starting at age 5, OIT from around age 4 and up, and Xolair from age 1. Adult patients are equally eligible and benefit from all three treatments.
Appointments, Insurance & Locations
You can request an appointment in three ways:
- Online: florida-allergy.com/patients/request-an-appointment/
- By phone: 1.877.4.ALLERGY (1-877-425-5374)
- In person: Visit any of our three Food Allergy Center locations — Aventura, Palmetto Bay, or Plantation
FCACC accepts most major insurance plans. A current list of accepted insurances is available at florida-allergy.com. Insurance coverage for specific treatments, particularly Xolair, may require prior authorization. Our team will assist you with this process.
Telemedicine visits are available for certain aspects of care, including SLIT follow-up. Ask your allergist whether telemedicine is appropriate for your specific treatment plan.
Yes. FCAAC offers payment plan options. Please visit florida-allergy.com/patients/payment-plans/ or ask our front desk team for details.
Please bring:
- A photo ID and insurance card
- A list of your current medications, including any antihistamines or biologics
- Records of prior allergy testing (skin test or IgE blood test results), if available
- A written or verbal description of any prior allergic reactions
- Your epinephrine auto-injector(s)
Our team is happy to assist. Call us at 1.877.4.ALLERGY or visit florida-allergy.com/about-us/contact-us/.