Itulazax (Betula Verrucosa (108))

Itulazax is used in allergy immunotherapy to address birch‑pollen‑related allergic conditions.

• Seasonal allergic rhinitis: reduces nasal congestion, sneezing and itching caused by birch pollen exposure.
• Allergic conjunctivitis: alleviates eye redness, tearing and itching associated with birch pollen.
• Birch‑pollen‑induced asthma (adjunctive): helps improve respiratory symptoms and decrease reliance on rescue medication in patients with asthma triggered by birch pollen.

• Betula verrucosa extract works by presenting sublingual birch pollen allergens to the immune system, which promotes the production of blocking IgG4 antibodies and reduces allergen‑specific IgE. This immunomodulation shifts T‑helper cell responses from a Th2‑dominant profile toward Th1, fostering immune tolerance and decreasing inflammatory mediator release during subsequent birch pollen exposure.

Sublingual administration of Itulazax may be associated with local and systemic reactions.

Common Side Effects

• Oral itching: mild itching or tingling in the mouth after sublingual dosing.
• Throat irritation: transient soreness or scratchy sensation in the throat.
• Nasal congestion: temporary blockage or runny nose following exposure.
• Mild gastrointestinal upset: occasional nausea or abdominal discomfort.

Serious or Rare Side Effects

• Anaphylaxis: severe, potentially life‑threatening allergic reaction requiring immediate medical attention.
• Angioedema: swelling of the lips, tongue or airway that may compromise breathing.
• Persistent asthma exacerbation: worsening of asthma symptoms despite therapy.

When prescribing Itulazax, clinicians should consider several precautionary measures to ensure safe use.

• Patient selection: confirm documented birch pollen sensitivity through skin testing or specific IgE before initiation.
• Initial dosing: start under medical supervision to monitor for acute reactions.
• Concomitant immunotherapy: avoid simultaneous use of other allergen extracts without specialist guidance.
• Pregnancy and lactation: use only if potential benefit justifies uncertain risk, as safety data are limited.
• Asthma control: ensure baseline asthma is well‑controlled before adding sublingual therapy.
• Store at ambient temperature: keep below 25°C in the original container, protect from moisture and direct sunlight.

Itulazax may interact with certain medications or conditions that affect immune response.

Major Interactions (Avoid)

• Systemic immunosuppressants: concurrent use may diminish the immunotherapeutic effect of the extract.
• Beta‑blockers: may mask early signs of anaphylaxis and complicate emergency treatment.

Moderate Interactions (Monitor Closely)

• Antihistamines: may reduce local side effects but could interfere with the intended immune modulation if taken immediately before dosing.
• ACE inhibitors: occasional reports of increased angioedema risk when combined with allergen extracts.
• Other allergen immunotherapies: simultaneous administration may increase risk of systemic reactions; coordinate with an allergist.