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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Anthoxanthum Odoratum
Brand Name
Standardized Sweet Vernal Grass
Generic Name
Anthoxanthum Odoratum
Active Ingredient
Anthoxanthum Odoratum PollenCategory
Standardized Pollen Allergenic Extract [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 100000 [BAU]/mL | INJECTION | CUTANEOUS, INTRADERMAL, SUBCUTANEOUS | 49643-318 |
Detailed information about Standardized Sweet Vernal Grass
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Standardized Sweet Vernal Grass, you must consult a qualified healthcare professional.
Anthoxanthum Odoratum Pollen is a standardized allergenic extract used in immunotherapy to treat allergic rhinitis and conjunctivitis. It belongs to the class of Standardized Pollen Allergenic Extracts and works by desensitizing the immune system to grass pollen allergens.
The dosage for Anthoxanthum Odoratum Pollen is highly individualized and depends on whether the patient is receiving Sublingual Immunotherapy (SLIT) or Subcutaneous Immunotherapy (SCIT).
For Sublingual Immunotherapy (SLIT), the typical adult dose (often as part of a 5-grass extract) involves a titration phase followed by a maintenance phase. The maintenance dose is usually 300 IR (Index of Reactivity) taken once daily. Treatment typically begins 4 months before the expected start of the grass pollen season and continues throughout the season.
For Subcutaneous Immunotherapy (SCIT), dosing is measured in Bioequivalent Allergy Units (BAU). A common starting dose is 0.05 mL of a 1:10,000 w/v dilution, gradually increasing weekly or bi-weekly until a maintenance dose (e.g., 0.5 mL of a 10,000 BAU/mL concentration) is reached. The exact schedule is determined by the physician based on the patient's sensitivity and reaction to the injections.
Anthoxanthum Odoratum Pollen extracts are generally approved for use in children aged 5 years and older. The dosing for children is typically the same as the adult dose for sublingual tablets (e.g., 300 IR daily for the 5-grass extract). For subcutaneous injections, pediatric dosing is carefully titrated by an allergist, often starting at even lower concentrations to ensure safety. It is not currently approved for children under the age of 5 due to limited safety data and the difficulty of administering sublingual medication or monitoring for anaphylaxis in very young children.
No specific dosage adjustments are required for patients with renal impairment, as the proteins are not cleared by the kidneys in a manner that would lead to systemic toxicity.
No dosage adjustments are necessary for hepatic impairment, as the extract does not undergo hepatic metabolism via the CYP450 system.
Clinical trials have included limited numbers of patients over age 65. Healthcare providers should use caution and consider the patient's overall health and ability to tolerate potential systemic reactions or use an epinephrine auto-injector.
For Sublingual Tablets:
For Subcutaneous Injections:
If a dose of the sublingual tablet is missed, skip the missed dose and take the next dose at the regularly scheduled time. Do not double the dose. If more than one or two doses are missed, contact your healthcare provider, as you may need to restart the titration or discontinue the treatment. For injections, if an appointment is missed, contact your allergist to adjust the schedule; missing multiple injections usually requires a reduction in the next dose to prevent reactions.
Signs of overdose (taking more than the prescribed sublingual dose) include severe local reactions (swelling of the tongue or mouth) or systemic allergic reactions. In the event of an overdose, seek emergency medical attention immediately. Treatment is supportive and may involve the administration of antihistamines or epinephrine if anaphylaxis occurs.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
Because Anthoxanthum Odoratum Pollen is an allergen extract, the most common side effects are localized allergic reactions at the site of administration. For sublingual administration, these include:
These symptoms are typically most severe during the first week of treatment and tend to diminish as the body becomes desensitized.
> Warning: Stop taking Anthoxanthum Odoratum Pollen and call your doctor immediately if you experience any of these.
The long-term use of Anthoxanthum Odoratum Pollen is generally well-tolerated. The primary long-term effect is a sustained reduction in allergy symptoms even after the treatment is discontinued (usually after 3 years of therapy). However, patients should be monitored for the late development of Eosinophilic Esophagitis. There is no evidence that long-term use causes organ toxicity or increases the risk of malignancy.
Anthoxanthum Odoratum Pollen extracts (especially SLIT formulations like Oralair) carry an FDA Black Box Warning regarding the risk of severe allergic reactions.
Summary of Warning:
Report any unusual symptoms to your healthcare provider.
Anthoxanthum Odoratum Pollen is a potent immunotherapeutic agent. It is not a medication for the immediate relief of allergy symptoms (like an antihistamine) but is intended for long-term immune modification. Patients must be aware that every dose carries a small but real risk of a systemic allergic reaction. It is vital that the patient is capable of recognizing the early signs of anaphylaxis and is willing and able to use an epinephrine auto-injector if necessary.
As noted in the side effects section, the FDA has issued a Black Box Warning for sublingual grass pollen extracts. This warning emphasizes that the first dose must be supervised by a medical professional and that patients with uncontrolled asthma are at the highest risk for fatal respiratory complications. No FDA black box warnings exist for the non-standardized diagnostic extracts, but the risk of anaphylaxis remains inherent to all allergenic products.
While routine blood work (like liver or kidney function tests) is not required, patients must be monitored for:
Anthoxanthum Odoratum Pollen does not typically cause drowsiness or cognitive impairment. However, if a patient experiences a systemic reaction or uses epinephrine, they should not drive and should seek emergency care.
There is no direct pharmacological interaction between alcohol and Anthoxanthum Odoratum Pollen. However, alcohol consumption can cause vasodilation and may theoretically increase the rate of allergen absorption or mask the early symptoms of an allergic reaction. It is generally advised to avoid alcohol shortly before and after taking the dose.
There is no 'withdrawal syndrome' associated with stopping Anthoxanthum Odoratum Pollen. However, stopping the treatment prematurely (before the recommended 3-year course) may result in the return of allergy symptoms. If treatment is stopped for more than a few days, the patient must consult their doctor before restarting, as a dose reduction or re-titration may be necessary to ensure safety.
> Important: Discuss all your medical conditions with your healthcare provider before starting Anthoxanthum Odoratum Pollen.
There are no known direct food interactions with Anthoxanthum Odoratum Pollen. However, patients with Oral Allergy Syndrome (OAS) may experience cross-reactivity. For example, some people allergic to grass pollen also react to certain fruits (like melons or oranges). Eating these foods immediately after a dose may worsen oral itching or swelling.
There is limited data on herbal interactions. However, supplements that affect the immune system (such as Echinacea or Astragalus) should be used with caution, as they could theoretically interfere with the desensitization process. Always inform your doctor of any supplements you are taking.
For each major interaction, the mechanism usually involves either a pharmacodynamic interference with the body's response to the allergen or an interference with the emergency medications used to treat a reaction. The management strategy always involves a thorough risk-benefit analysis by the prescribing allergist.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Anthoxanthum Odoratum Pollen must NEVER be used in the following circumstances:
Conditions requiring careful risk-benefit analysis include:
Anthoxanthum Odoratum Pollen belongs to the Poaceae family. There is high cross-reactivity between Sweet Vernal Grass and other grasses such as:
Patients allergic to one of these grasses are almost certainly allergic to the others. This cross-sensitivity is the basis for using multi-grass extracts for broad-spectrum grass allergy treatment.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Anthoxanthum Odoratum Pollen.
Anthoxanthum Odoratum Pollen is generally classified as Pregnancy Category B or C (depending on the specific manufacturer). There is no evidence of teratogenicity (birth defects) in animal studies. However, the primary risk during pregnancy is not the drug itself, but the risk of a systemic allergic reaction (anaphylaxis) in the mother, which can cause fetal hypoxia (lack of oxygen).
Clinical Recommendation: It is generally advised NOT to start new immunotherapy during pregnancy. If a woman is already on a maintenance dose and tolerating it well, the healthcare provider may choose to continue the treatment, but increasing the dose during pregnancy is typically avoided.
It is unknown whether the allergenic proteins or their metabolites are excreted in human milk. However, because these are proteins that are digested in the gastrointestinal tract, it is highly unlikely that they would affect a nursing infant. The risk-benefit profile usually favors continuing treatment if it is necessary for the mother's respiratory health.
Anthoxanthum Odoratum Pollen is approved for children as young as 5 years old. Clinical trials have demonstrated that immunotherapy is effective in children and may even prevent the 'allergic march'—the progression from allergic rhinitis to asthma. Parents must be carefully trained to monitor their children for side effects and to use a pediatric epinephrine auto-injector. It is not approved for children under 5 years of age.
Patients over the age of 65 may have a higher prevalence of comorbid conditions (like heart disease) that could make a systemic allergic reaction more dangerous. Additionally, elderly patients are more likely to be taking medications like beta-blockers or ACE inhibitors. Dosing should be approached with caution, and the clinician must ensure the patient has the manual dexterity to use an epinephrine device.
No dose adjustment is required. The active proteins are localized to the immune system and are not cleared by the kidneys. There is no evidence of nephrotoxicity associated with allergenic extracts.
No dose adjustment is required. The extract does not undergo significant hepatic metabolism. Patients with liver disease can safely use this medication provided they are otherwise candidates for immunotherapy.
> Important: Special populations require individualized medical assessment.
Anthoxanthum Odoratum Pollen acts as a biological response modifier. Its molecular mechanism involves the induction of peripheral T-cell tolerance. Upon administration, the major allergens—specifically Anth o 1 (a beta-expansin) and Anth o 5 (a ribonuclease)—are processed by antigen-presenting cells (APCs). These APCs present the allergen peptides to naive T-cells in the presence of specific cytokines, favoring the differentiation of Regulatory T-cells (Tregs). These Tregs produce IL-10, which suppresses IgE production by B-cells and instead promotes the production of IgG4. IgG4 acts as a 'decoy' or 'blocking' antibody, preventing the allergen from binding to IgE on mast cells, thereby inhibiting the release of histamine and other inflammatory mediators.
The pharmacodynamic effect of Anthoxanthum Odoratum Pollen is slow-onset. While some immunological changes occur within weeks, the clinical reduction in symptoms usually requires 2-4 months of daily treatment. The duration of effect is significant; a completed 3-year course of treatment can provide relief for several years after discontinuation. There is no evidence of the development of pharmacological tolerance (tachyphylaxis); rather, the body becomes more 'tolerant' in an immunological sense.
| Parameter | Value |
|---|---|
| Bioavailability | Negligible systemic bioavailability as intact proteins |
| Protein Binding | N/A (Active ingredients are themselves proteins) |
| Half-life | Local residency in mucosa: hours; Immunological effect: months |
| Tmax | N/A (Local action) |
| Metabolism | Proteolysis by cellular enzymes |
| Excretion | Cellular degradation and recycling of amino acids |
Anthoxanthum Odoratum Pollen extract is a complex biological mixture. It contains various proteins, glycoproteins, and polysaccharides. The primary allergenic proteins are Anth o 1 (approx. 30-35 kDa) and Anth o 5 (approx. 25-30 kDa). The extract is typically standardized based on its biological potency, measured in Bioequivalent Allergy Units (BAU) or Index of Reactivity (IR), rather than a simple molecular weight or formula.
This agent is a member of the Standardized Pollen Allergenic Extract [EPC] class. It is closely related to other grass pollen extracts like Timothy Grass (Phleum pratense) and is often found in combination products used for '5-grass' sublingual therapy.
Common questions about Standardized Sweet Vernal Grass
Anthoxanthum Odoratum Pollen, also known as Sweet Vernal Grass pollen, is used in allergen immunotherapy to treat patients with seasonal allergic rhinitis (hay fever) and allergic conjunctivitis. It is specifically intended for individuals who have a confirmed allergy to this grass and whose symptoms are not well-controlled by standard allergy medications. The treatment works by gradually desensitizing the immune system to the pollen, reducing the severity of symptoms like sneezing, runny nose, and itchy eyes. It is available as both sublingual tablets and subcutaneous injections. This therapy is considered a disease-modifying treatment because it addresses the underlying cause of the allergy rather than just the symptoms.
The most common side effects are localized allergic reactions at the site where the medication is administered. For those taking sublingual (under-the-tongue) tablets, this often includes itching of the mouth, swelling of the tongue, and a scratchy or irritated throat. These symptoms typically appear shortly after taking the dose and usually resolve within an hour. For those receiving injections, common side effects include redness, itching, and swelling at the injection site. Most patients find that these local reactions become less severe as the body adjusts to the treatment over the first few weeks. However, if swelling is severe or causes difficulty swallowing, you should contact your doctor immediately.
There is no known direct chemical interaction between alcohol and Anthoxanthum Odoratum Pollen. However, most healthcare providers recommend avoiding alcohol shortly before and after taking your dose, especially during the initial titration phase. Alcohol can cause blood vessels to dilate, which might theoretically increase the speed at which the allergen is absorbed into your system, potentially increasing the risk of a reaction. Furthermore, alcohol can impair your ability to recognize the early warning signs of a serious allergic reaction or your ability to use an epinephrine auto-injector correctly. It is best to discuss your alcohol consumption habits with your allergist before starting treatment.
The safety of starting Anthoxanthum Odoratum Pollen during pregnancy has not been fully established, and it is generally not recommended to begin this therapy while pregnant. The primary concern is not that the pollen extract will cause birth defects, but that a severe allergic reaction (anaphylaxis) in the mother could reduce oxygen flow to the baby. If you are already on a stable maintenance dose and become pregnant, your doctor may allow you to continue the treatment since your body has already shown it can tolerate the dose. However, the dose is usually not increased during pregnancy. Always inform your healthcare provider immediately if you become pregnant or plan to become pregnant while on immunotherapy.
Anthoxanthum Odoratum Pollen is a long-term treatment and does not provide immediate relief like an antihistamine or decongestant. Most patients begin to notice a reduction in their allergy symptoms after 2 to 4 months of consistent daily use. To get the maximum benefit for a specific grass pollen season, treatment is usually started about 4 months before the season begins. For the best long-term results, including the possibility of permanent relief, clinical guidelines typically recommend continuing the treatment for 3 consecutive years. Your doctor will monitor your progress to determine if the treatment is effective for you.
You can stop taking Anthoxanthum Odoratum Pollen suddenly without experiencing withdrawal symptoms, as it is not an addictive medication. However, if you stop the treatment before the recommended 3-year course is complete, your allergy symptoms are likely to return during the next pollen season. If you miss more than a few days of treatment, you should not simply restart at your usual dose, as your sensitivity may have increased, raising the risk of an allergic reaction. Always contact your healthcare provider if you need to stop the medication for any reason, such as for dental surgery or due to illness, so they can advise you on how to safely resume.
If you miss a dose of the sublingual tablet, you should skip the missed dose and take your next scheduled dose the following day. Never take two doses at once to make up for a missed one. If you miss more than two consecutive doses, you must call your doctor before taking another one, as they may need to adjust your dose or have you come into the office for your next administration to ensure safety. For those receiving injections, missing an appointment requires a call to the allergist to reschedule; they will determine if your dose needs to be lowered for that visit to prevent a reaction.
There is no clinical evidence to suggest that Anthoxanthum Odoratum Pollen causes weight gain. Unlike systemic corticosteroids (such as prednisone), which are known to affect metabolism and appetite, allergenic extracts are proteins that work locally on the immune system. They do not contain hormones or calories that would contribute to weight changes. If you experience unexpected weight gain while on this treatment, it is likely due to other factors, and you should discuss it with your healthcare provider to identify the underlying cause.
Anthoxanthum Odoratum Pollen can be taken with many other medications, but there are some critical exceptions. It should be used with extreme caution in patients taking beta-blockers, as these drugs can prevent epinephrine from working correctly during an emergency. It may also interact with MAO inhibitors or tricyclic antidepressants, which can make the heart more sensitive to epinephrine. While you can continue to take standard allergy medications like antihistamines, you should inform your doctor, as these can sometimes hide the early signs of a reaction to the immunotherapy. Always provide your doctor with a full list of all prescriptions, over-the-counter drugs, and supplements you are taking.
Anthoxanthum Odoratum Pollen is a biological product, and the concept of 'generic' versions is different than for chemical drugs. While there isn't a 'generic' in the traditional sense, there are various manufacturers that produce Sweet Vernal Grass extracts. These extracts are standardized to ensure they have the same biological potency, but they are not always considered interchangeable. If you are prescribed a specific brand of sublingual tablet, like Oralair (which contains Sweet Vernal Grass), your pharmacist cannot simply swap it for another product without your doctor's approval. Most of these extracts are covered by insurance, but costs can vary based on the specific formulation and manufacturer.
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