Speeding to Relief: Cluster and Rush Allergy Shots

Allergy shots

If you’ve been looking into allergy shots (immunotherapy) to control your allergy symptoms, you’re on the right track. Allergy shots are over 90% effective at reducing allergy symptoms when appropriately followed. An immunotherapy treatment plan is made up of two phases: build-up and maintenance. The build-up phase is just that – a “build-up” to a steady “maintenance” dosage, when patients begin to feel the results.

Family Allergy & Asthma offers three build-up schedules for allergy shots: traditional, cluster, and rush. The traditional schedule requires 1-3 shots a week for 3 to 12 months to reach the maintenance phase. But when allergy and asthma symptoms are relentless, waiting 12 months for relief can seem endless. That’s why we offer cluster and rushschedules for patients who want to speed up that timeline.

Cluster Allergy Shots

Cluster build immunotherapy is a quicker approach to building up resistance to allergens. This schedule will help patients reach the maintenance phase within 5-6 weeks. Cluster shots require 8-10 scheduled appointments from 30 minutes to 2 hours long. Injections are given 2-3 times at each visit with a 30-minute waiting period after each injection.

Rush Allergy Shots

Rush immunotherapy offers the fastest approach to reach maintenance. This form of allergy injections requires patients to receive increasing doses of a mixture of the allergens to which they are allergic over the course of one day. The appointment lasts approximately eight hours, but the patient will complete most of the build-up phase. After this appointment, patients visit weekly for their allergy injections and will reach maintenance within 16 weeks.

Note: While the majority of insurance plans cover traditional and accelerated schedules, some do not.

What to Expect for Your Family Allergy Appointments

Cluster and rush immunotherapy schedules are more convenient, but they are no small undertaking. Therefore, they require some preparation beforehand. Due to the large dose of allergens you will be receiving, both schedules require oral medication before the appointment. The medication reduces the risk of having a severe allergic reaction. Your doctor will prescribe the medications you should take before your appointment.

For Cluster: Take medication(s) 2 hours prior to each cluster injection appointment.

Pre-medications prior to Cluster visits:

  • Prednisone 20mg: Take 1 tablet by mouth 2 hours prior to injections
  • Singlulair 10mg/5mg: Take 1 tablet by mouth 2 hours prior to injections
  • Famotidine 20mg: Take 1 tablet by mouth 2 hours prior to injections
  • Antihistamine (fexofenadine, cetirizine, or levocetirizine): Take 1 tablet by mouth 2 hours prior to injections

No pre-medication is required for 1st weekly visit after Cluster regimen completed.

Beta blockers to be held the morning of Cluster visit and for at least 1 hour after last injection, unless otherwise specified by the ordering provider.

For Rush: Take the first dose of medications with dinner the day before your appointment. Take the second dose 2 hours before your appointment. Take the last dose before your 1st weekly visit after the rush appointment.

We recommend you wear short sleeves to your appointments so your arm is easily accessible. Once you arrive, be sure to pick a cozy spot in our waiting room since you will be at our office for a few hours. Some of our offices have a designated area for cluster and rush patients. Once you start your session, it’s important to stay and finish it, so be sure to come prepared with anything you might need! Check the list below for our recommendations on what to bring.

What to bring to cluster & rush allergy shot graphics

#1) Something to occupy yourself

Cluster shots can take up to a few hours and rush shots take a full day. You will want something to keep you busy in between shots.

#2) Sweater or Jacket

Since you will be wearing short sleeves, you may get chilly in the lobby while waiting for shots. Short sleeves are recommended so the shots can be easily administered in your upper arm.

#3) Snacks and Water

Water is essential because staying hydrated is always important. Once shots start, you will have to stay in our office until they are complete. Rumbling tummies can make the experience less than enjoyable.


With cluster and rush allergy shots, symptom relief is closer than you might think. If you’re interested in changing to an accelerated shot schedule or starting immunotherapy, schedule an appointment to talk to your doctor. For other questions about allergy shots, visit our education page.