Around 16 million people in the UK suffer from hay fever, but only a small fraction will benefit from a newly approved treatment called Itulazax. Recently backed by NICE, Itulazax is the first under-the-tongue immunotherapy tablet for people allergic to birch tree pollen.
This new treatment works by gently retraining the immune system to tolerate birch pollen, instead of simply suppressing symptoms. Each daily tablet contains a freeze-dried extract of Betula verrucosa and is taken under the tongue for three years.
Unlike over-the-counter antihistamines or steroid sprays, Itulazax tackles the root cause. Clinical trials revealed significant improvements in sneezing, itchy eyes, nasal congestion and fatigue, with many users needing fewer medications. Mild mouth-tingling was the most common side effect.
But here’s the catch. Out of 16 million hay fever sufferers in the UK, only around 27,000 are confirmed to have birch pollen allergy. That’s just 0.17% of all sufferers. To qualify for Itulazax, patients must undergo a skin prick or blood test to confirm this specific allergy.
NHS England plans to begin prescribing the treatment within three months of NICE’s final guidance, issued on 21 July 2025. The treatment is not yet available in Scotland, where the manufacturer has not submitted the necessary data for approval.
Itulazax is not a one-size-fits-all solution. But for a small group of people who suffer intensely every spring, it may finally offer lasting relief.
Want to find out if you’re eligible?
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