Grazax (Phleum Pratense (225))

Grazax is indicated for the management of grass pollen‑induced allergic conditions in adults and children, and it is prescribed as part of a structured immunotherapy regimen.

• Grass pollen‑induced allergic rhinitis (hay fever) in patients with a confirmed sensitivity.
• Allergic rhinoconjunctivitis caused by grass pollen, when symptoms are seasonal.
• Prevention of seasonal allergy symptoms during the grass pollen season.
• Adjunct to standard pharmacotherapy for patients seeking disease‑modifying treatment.
• Long‑term immunotherapy to reduce the need for rescue antihistamines.
• Suitable for patients who have experienced inadequate control with conventional symptomatic medications.

The safety profile of Grazax reflects the typical reactions associated with sublingual allergen immunotherapy.

Common

• Mild itching or tingling sensation under the tongue that usually resolves within minutes.
• Transient oral discomfort, including throat irritation or mild soreness, occurring shortly after placement of the tablet.
• Nasal itching, sneezing, or watery eyes that may appear within the first hour of dosing and are typically brief.

Serious

• Anaphylaxis or a severe systemic allergic reaction characterized by rapid onset of symptoms such as difficulty breathing, drop in blood pressure, or widespread hives.
• Persistent wheezing, bronchospasm, or tightening of the chest that does not improve with usual rescue inhalers.
• Angioedema involving the lips, tongue, or airway, which can compromise breathing and requires immediate medical attention.

Before starting Grazax, patients and clinicians should consider several precautionary measures to ensure safe administration.

• Confirmed diagnosis of grass pollen allergy through skin testing or specific IgE measurement is required.
• Initiate therapy under medical supervision, especially the first dose, to monitor for acute reactions.
• Patients with uncontrolled asthma or a history of severe allergic reactions should be evaluated before use.
• Avoid administration on the same day as other allergen immunotherapies to reduce cumulative risk.
• Do not swallow the tablet; allow it to dissolve completely under the tongue.
• Pregnant or breastfeeding individuals should discuss potential risks with their healthcare provider.

Grazax may interact with certain medications or conditions; awareness of these interactions helps minimize adverse outcomes.

Avoid

• Concomitant use of other sublingual or subcutaneous allergen immunotherapies, which can increase the risk of systemic allergic reactions.
• Administration of beta‑blockers in patients with severe asthma, as they may blunt the response to emergency treatment of anaphylaxis.

Use with caution

• Antihistamines or leukotriene receptor antagonists, which may mask early signs of an allergic reaction and should be reviewed by a clinician.
• Systemic corticosteroids, especially at high doses, because they can alter immune response to the immunotherapy.
• ACE inhibitors, which have been associated with increased incidence of angioedema in susceptible individuals.