Oralair

Oralair (Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract) Sublingual Tablet is an allergen extract used as immunotherapy for the treatment of grass pollen-induced allergic rhinitis with or without conjunctivitis confirmed by positive skin test or in vitro testing for pollen-specific IgE antibodies for any of the five grass species contained in this product. Oralair is not indicated for the immediate relief of allergy symptoms. Common side effects of Oralair include:

• itching of the mouth/tongue/ears
• throat irritation or pain
• mouth/lip/tongue swelling
• cough
• abdominal pain
• indigestion
• mouth numbness, or
• hives

The adult dose of Oralair is 300 IR (index of reactivity) daily. Oralair may interact with other drugs. Tell your doctor all medications and supplements you use. Tell your doctor if you are pregnant or plan to become pregnant before using Oralair. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Our Oralair (Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract) Sublingual Tablet Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

 

Oralair Consumer Information

Mixed grass pollens allergen extract may cause a severe allergic reaction. Stop taking the medicine and get emergency medical help if you have any of these signs of an allergic reaction:

• severe dizziness or a light-headed feeling (like you might pass out);
• fast heart rate;
• stomach pain, vomiting, diarrhea;
• hives, itching, flushing (warmth, redness, or tingly feeling);
• cough, chest tightness, wheezing, trouble breathing; or
• swelling of your face, lips, tongue, or throat.

If you stop taking mixed grass pollens allergen extract after having an allergic reaction, do not start taking the medicine again without your doctor's advice.

Call your doctor at once if you have:

• severe mouth or throat irritation;
• breathing problems; or
• choking feeling, chest pain, trouble swallowing.

Common side effects may include:

• pain, swelling, or itching of your mouth or tongue;
• throat irritation;
• cough, sore throat, sinus pain; or
• itching in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Oralair (Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract Sublingual Tablets)

 

Oralair Professional Information

SIDE EFFECTS

Adverse reactions reported in ≥ 5% of patients were: oral pruritus, throat irritation, ear pruritus, mouth edema, tongue pruritus, cough, oropharyngeal pain.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rate observed in practice.

Adults

Overall, in 6 placebo-controlled clinical trials, 1,038 adults 18 through 65 years of age received at least one dose of ORALAIR 300IR, of whom 611 (59%) completed at least four months of therapy. Of study participants, 56% were male, 17% had a history of mild intermittent asthma at study entry, and 64% were polysensitized. Data on race and ethnicity were not systematically captured in the five European studies (N=805). In the US study (N=233), a limited number of patients reported their race as other than White/Caucasian (Black/African American: 5.6%, Asian: 2.6%, Other: 2.1%) or their ethnicity as Hispanic or Latino (3.0%). Adverse events were captured on a daily diary card that did not solicit for specific adverse events.

Across the six clinical studies, adverse reactions reported at an incidence of ≥ 2% of ORALAIR recipients and at a greater incidence than that in participants treated with placebo are listed in Table 2.

Table 2: Adverse Reactions Reported by ≥ 2% of Adults Receiving ORALAIR 300 IR and at a Greater Incidence than that in Participants Treated with Placebo

Adverse Reactions	ORALAIR 300 IR (N=1,038)	PLACEBO (N=840)
Ear and labyrinth disorders
Ear pruritus	8.4%	0.6%
Respiratory, thoracic and mediastinal disorders
Throat irritation	22.0%	3.7%
Cough	7.3%	5.9%
Oropharyngeal pain	5.1%	3.7%
Pharyngeal edema	3.8%	0.1%
Gastrointestinal disorders
Oral pruritus	25.1%	5.0%
Edema mouth	8.2%	0.6%
Tongue pruritus	7.9%	0.7%
Lip edema	4.4%	0.4%
Paraesthesia oral	4.3%	1.0%
Abdominal pain	4.2%	1.3%
Dyspepsia	3.9%	0.4%
Tongue edema	2.7%	0.1%
Hypoaesthesia oral	2.2%	0.1%
Stomatitis	2.1%	0.7%

Additional adverse reactions of interest that occurred in < 2% of ORALAIR recipients include dysphagia, nausea, vomiting, esophageal pain, gastritis, and gastroesophageal reflux.

Children And Adolescents

Overall, in placebo-controlled clinical trials, 154 children and adolescents 5 through 17 years of age received ORALAIR 300 IR, of whom 147 were exposed for more than 3 months. Of study participants, 66% were male, and 21% had a history of mild intermittent asthma at study entry. Data on race and ethnicity were not systematically captured.

The safety profile in the pediatric population, was generally similar to that of adults. In pediatric patients receiving ORALAIR, additional adverse reactions reported at an incidence of ≥ 2% and at a greater incidence than that in participants treated with placebo are listed in Table 3.

Table 3: Additional Adverse Reactions Reported by ≥ 2% of Children and Adolescents Receiving ORALAIR 300 IR and at a Greater Incidence than that in Participants Treated with Placebo

Adverse Reactions	ORALAIR 300 IR (N=154)	PLACEBO (N=158)
Infections and infestations
Tonsillitis	5.8%	3.2%
Upper respiratory tract infection	3.9%	1.9%
Respiratory, thoracic and mediastinal disorders
Asthma	7.1%	3.8%
Dysphonia	2.6%	1.3%
Gastrointestinal disorders
Lip pruritus	3.2%	0.0%
Skin and subcutaneous tissue disorders
Atopic dermatitis	3.2%	0.6%

Serious Adverse Reactions

At least 1 serious adverse event was reported in 22 of 1514 (1.5%) subjects who received ORALAIR at any dose, and 11 of 840 (1.1%) of placebo recipients. Of the 22 serious adverse events in the ORALAIR recipients, 2 were considered “definitely related” to ORALAIR.

The first subject was an adult who experienced a severe hypersensitivity reaction which began 5 minutes after administration of ORALAIR. The symptoms were violent coughing and marked dyspnea. The subject was treated with antihistamines, salbutamol and prednisolone and the reaction resolved without sequelae.

The second subject was an adult who experienced severe laryngeal edema. The subject was treated with prednisolone and event resolved without sequelae.

There was also one case of gastroenteritis with an onset on Day 93 of therapy that was possibly related to ORALAIR.

Postmarketing Experience

Post Marketing Safety Studies

A total of 1728 individuals (808 adults; 920 children 5 through 17 years of age) received ORALAIR in post marketing safety studies. Reported adverse reactions included: anaphylactic reaction, oral allergy syndrome, flushing, dyspnea, laryngeal edema, and diarrhea.

Spontaneous Postmarketing Reports

In addition to adverse reactions reported in clinical and post marketing safety studies, the following adverse reactions have been identified during post approval use of ORALAIR. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure: autoimmune thyroiditis, eosinophilic myocarditis, eosinophilic esophagitis, palpitations, tachycardia, hypotension, loss of consciousness, circulatory collapse, malaise, pallor, peripheral vascular disorder, stridor, angioedema, face edema, weight decreased, wheezing, exacerbation of asthma, chest discomfort, oropharyngeal paresthesia, oropharyngeal blistering, headache, dizziness, tinnitus, asthenia, somnolence, anxiety, rash, pruritus, salivary gland enlargement and/or hypersecretion, dry mouth, dry eye, influenza-like syndrome, lymphadenopathy, eosinophil count increased.

Read the entire FDA prescribing information for Oralair (Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract Sublingual Tablets)