Itulatek has the following Warnings and Precautions: Itulatek should only be prescribed and initiated by physicians who are adequately trained and experienced in treating respiratory allergic diseases. Systemic allergic reactions, including severe local allergic reactions, that may require emergency administration of epinephrine, bronchodilators, or systemic corticosteroids can occur. The first dose of Itulatek should be administered in the physician’s office under medical supervision. The patient must be observed for at least 30 minutes. Before you start taking Itulatek sublingual immunotherapy for allergies, inform your doctor of the following:, All the prescription and over-the-counter medications you take, Your allergies, Your past medical history and current health problems, If you are pregnant or breastfeeding, Patients may experience local swelling which can become severe over time. If this occurs, Itulatek should be stopped., Women who are pregnant should not take Itulatek., Caution should be used in patients with active systemic autoimmune disorders and in patients with immune problems or malignant neoplasia., Itulatek can cause eosinophilic esophagitis., Itulatek can cause severe reactions that can become life-threatening. These reactions include fainting, low blood pressure, rapid heart rate, runny dose, sneezing, shortness of breath, wheezing, trouble breathing, chest discomfort, stomach pain, vomiting, diarrhea, rash, itching, flushing, and hives. Patients who develop severe allergic reactions should seek emergency care right away. Patients with certain heart problems, including unstable angina (chest pain), recent heart attack, significant heart arrhythmias, and uncontrolled high blood pressure may be at increased risk., Itulatek should be temporarily discontinued in patients with oral inflammation or wounds until healed., Patients with unstable severe or uncontrolled asthma should not take Itulatek. All the prescription and over-the-counter medications you take, Your allergies, Your past medical history and current health problems, If you are pregnant or breastfeeding