What is Grazax?
Grazax is a sublingual (under the tongue) once daily immunotherapy treatment that is used in children and adults who have severe allergies to grass pollen (Timothy grass). Grazax may also reduce symptoms caused by other grass pollens. It comes in the form of a tablet that dissolves under the tongue. Taken daily, Grazax can help the immune system develop a tolerance to grass pollen.
Grazax is taken daily for three years. If the treatment is to be successful and have long-term benefits, it is extremely important that Grazax is taken every day during the entire treatment period, unless there are troublesome side effects or the person taking Grazax is unwell.
When do I start Grazax?
The first dose of the immunotherapy will be administered in the Children’s Day Unit. You will be sent details of the date, time and place. You/your child will need to stay for approximately one hour after the first dose. During this time, your child will be monitored closely for any symptoms or signs of an unwanted allergic reaction. After this initial visit, your child will continue to take the treatment at home every day.
How do I take Grazax?
You take Grazax by placing the tablet under your tongue. The tablet needs to be held under the tongue for one minute without swallowing. No food or drink is permitted for five minutes after taking the Grazax tablet.
If you are taking any other sublingual immunotherapy medications, we recommend to leave at least ONE HOUR between different sublingual medications.
Important Points
Do not exercise for one hour before or after taking Grazax
Ensure the mouth is clear of food, rinse mouth if necessary
Remind/remember to hold the tablet under the tongue for one minute without swallowing. DO NOT chew or swallow the tablet
Do not eat or drink anything for five minutes after the Grazax tablet
Take Grazax at the same time every day, ideally in the morning.
Never take more than one Grazax tablet per day
Grazax is taken daily for three years.
When shouldn’t Grazax be taken?
Grazax works by stimulating and altering your immune system through the immune cells found in the lining of your mouth. Grazax should be missed on days when the person taking Grazax is unwell (as the immune system is already in ‘overdrive’) or if the mouth is tender, cut or inflamed.
Grazax daily treatment should be temporarily stopped if any of the following occur:
Asthma attack
Infection/viral illness
High temperature
Any injury or sores in the mouth (for example – cold sores, tooth removal/loss, trauma to mouth during sports injury).
On the day a vaccination is given and whilst experiencing the side effects of a vaccination
How should Grazax be restarted after a break or a missed dose?
- Grazax should be restarted once the acute phase of the illness/infection has passed.
- Grazax should be restarted after wounds in the mouth have healed or seven days after tooth extraction.
- If a dose is accidentally missed/forgotten – DO NOT take a double dose. Resume with the usual daily dose.
If your child’s Grazax tablets are stopped for seven days or less, please restart at home. You do not need to inform the allergy nurses.
If your child’s Grazax treatment has been stopped for more than seven days, please DO NOT resume at home and contact the allergy nurses. We may want to restart Grazax in the hospital.
Should other allergy medications be stopped while taking Grazax?
NO. Initially the advice is to remain on all the same allergy medications as usual. It may take up to a year after starting Grazax to notice an improvement in symptoms.
Over time it is anticipated that your child will be able to reduce or stop some or all of the allergy medications.
The allergy team will provide direction on how to reduce regular allergy medications at follow up clinic visits, depending on the severity of allergy symptoms.
Can any new medications be started whilst on Grazax?
Please discuss with a member of the allergy team before starting any new medications or having other immunotherapy treatment.
At any time during the treatment period of three years, please remember to inform the allergy team of any new medications your child is advised to take.
How to store Grazax
- Keep out of reach of children.
- Store Grazax in a dry location at room temperature. You do not need to keep Grazax in the refrigerator.
- Open each blister just before you take the tablet. DO NOT take tablets out of the blisters to store in a pillbox.
Repeat prescription
Please contact the GP or the Children’s Allergy Nurses for a refill of the Grazax when the last box has been opened.
In order to avoid interruption of treatment, it is important to request the next prescription of Grazax as soon as the last box of Grazax has been started.
If too many doses of Grazax have been missed during a period of time or if follow up clinic appointments are not attended, a decision may be made by the allergy team for Grazax treatment to be discontinued.
Back to topHow long will the beneficial effect of Grazax last?
This varies from one individual to another. In general, the effect of this treatment is expected to last for at least five years after initiation and up to ten years.
What are the possible risks of Grazax treatment?
Sublingual immunotherapy is very safe. Large studies on hundreds of children have never found any serious reactions. The most common side effects were itchiness in the mouth or ears, or mild allergy symptoms for example a runny nose or watery eyes, throat irritation and lip swelling after taking the Grazax tablet. These tend to happen immediately after you have administered the Grazax tablet and usually do not last longer than then ten to fifteen minutes. Itch and tingling can be managed by taking an antihistamine twenty to thirty minutes before taking the Grazax tablet.
Most symptoms occur on the first few days of treatment. These symptoms usually subside once the body gets used to the treatment, within two to three weeks. However, if symptoms persist or are troublesome, please contact the allergy team to discuss this.
Other rarer side effects include headaches, tiredness, abdominal pain, swelling of the tongue or lips, itchy hives on skin, eczema flare, sneezing, runny or blocked nose and watery itchy eyes. If these occur, take an antihistamine and inform a member of the allergy team.
Important
If your child develops begins to experience difficulty in swallowing particularly when eating food (feeling like the food is ‘stuck’ in their throat) or needs to wash food down with fluids, experiences heartburn or vomiting – please inform the allergy team immediately. This can be a sign of a rare complication of sublingual immunotherapy called Eosinophilic Oesophagitis.
If any severe or worrying side effects are experienced – please do not give your child any further Grazax tablets until you have discussed your concerns with the Children’s Allergy team.
Contact telephone numbers
Children’s Allergy Nurse Specialists
Paediatric Consultants
The Consultants secretary can be contacted using the telephone number below.
Out of hours
Phone the main hospital switchboard on the number below, and ask for the Paediatric Medical registrar on-call.