Allergen immunotherapy is the only treatment option that can alter the immune response to aeroallergens and venom allergens. This review will provide the allergist with an up-to-date summary of current research examining the safety of sublingual and subcutaneous allergen immunotherapy. Several clinical trials and retrospective studies assessing the overall safety of various treatments have been reported. The risk of systemic responses with subcutaneous immunotherapy remains minimal, but anaphylaxis can be deadly or near-fatal, therefore clinicians must be aware of the possibility of such occurrences. Local site application responses are typical with sublingual immunotherapy, but major anaphylactic episodes are extremely rare.

Subcutaneous and sublingual immunotherapy can help treat allergic rhinitis and venom hypersensitivity, but they should only be used by doctors who are acquainted with possible risk factors and who can manage treatment-related local and systemic allergic responses.