Birch Pollen SLIT on the NHS: Who Might Benefit from Itulazax®

NICE has approved Itulazax®, a daily under-the-tongue immunotherapy tablet, for people with moderate–severe birch pollen allergy who don’t get relief from usual medicines.

Who this helps: Adults and eligible young people with confirmed birch pollen allergy.

Key takeaways

• SLIT (sublingual immunotherapy) re-trains the immune system.

• Treatment usually starts outside pollen season.

• Taken daily for 3 years for long-term benefit.

  
  

What Itulazax is

A tablet dissolved under the tongue that helps reduce symptoms over time. Clinical studies show reduced allergy scores and less medication use.

Who might be eligible

• Confirmed birch allergy (skin test or blood test).

• Severe symptoms despite antihistamines/nasal sprays.

• Willing to commit to long-term daily dosing.

  
  

What to expect

• First dose under medical supervision.

• Common side effects: mouth/throat itching (settle with time).

• Benefits build gradually, noticeable in year 1–2.

  
  

When to seek help:If you develop breathing difficulties, throat swelling or severe reactions after a dose, seek urgent care.

References

• NICE (2025) First birch pollen immunotherapy recommended. Available at: https://www.nice.org.uk/news/articles/first-immunotherapy-for-severe-birch-tree-pollen-allergy-recommended-by-nice