Table 8.

Contraindications ^{a, d} to AIT with allergens

Subcutaneous administration (SCIT)	Sublingual administration (SLIT)
Partially controlled or uncontrolled bronchial asthma (classification according to the GINA guidelines, 2007 or NVL, see Tab. 9)	Partially controlled or uncontrolled bronchial asthma (classification according to the GINA guidelines, 2007 or NVL, see Tab. 9)
Diseases in which administration of epinephrine is contraindicated (except in the case of insect venom allergies)	no contraindication
Treatment with β-blockers (local or systemic application)b	preparation-specific differences, see product information leaflet
severe autoimmune diseasesc, immune defects, immunodeficiencies, immunosuppression	severe autoimmune diseasesc, immune defects, immunodeficiencies, immunosuppression
malignant neoplastic diseases with current disease relevance	malignant neoplastic diseases with current disease relevance
serious systemic reactions to AIT in the past	serious systemic reactions to AIT in the past
	acute, severe inflammatory disorder of the oral cavity
insufficient compliance	insufficient compliance

^a In justified individual cases and on the basis of a risk-benefit analysis, AIT may also be possible even with existing contraindications.

^b In Germany, treatment with ACE inhibitors is also currently a contraindication to SCIT with insect venom.

^c Diseases not among those severe autoimmune diseases that represent a contraindication to AIT include: Hashimoto thyroiditis, rheumatoid arthritis, ulcerative colitis and Crohn‘s disease, type-1 diabetes mellitus; see also Sect. 5.2

^d When evaluating contraindications, the product information leaflet corresponding to the particular product must be consulted.

GINA, global initiative for Asthma ; NVL, Nationale Versorgungsleitlinie, National disease management guideline; AIT, specific immunotherapy