ANIMAL ALLERGENS, AP HORSE HAIR AND DANDER
-
equus caballus hair and
equus caballus dander injection, solution
ANIMAL ALLERGENS, AP CATTLE HAIR AND DANDER
-
bos taurus hair and
bos taurus dander injection, solution
ANIMAL ALLERGENS, AP DOG HAIR AND DANDER CANIS SPP
-
canis lupus familiaris hair and
canis lupus familiaris dander injection, solution
ANIMAL ALLERGENS, DOG HAIR AND DANDER CANIS SPP.
-
canis lupus familiaris hair and
canis lupus familiaris dander injection, solution
ANIMAL ALLERGENS, FEATHER MIX
-
gallus gallus feather,
anas platyrhynchos feather and
anser anser feather injection, solution
ANIMAL ALLERGENS, GUINEA PIG HAIR AND DANDER
-
cavia porcellus hair and
cavia porcellus dander injection, solution
AP HOUSE DUST MIX
-
house dust injection, solution
DUST, HOUSE MIXTURE
-
house dust injection, solution
FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, BEEF BOVINE SPP.
-
beef injection, solution
FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, CHICKEN MEAT GALLUS SP.
-
poultry injection, solution
FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, EGG, WHITE GALLUS SP.
-
egg white injection, solution
FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, EGG, YOLK GALLUS SP.
-
egg yolk injection, solution
FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, PORK SUS SP.
-
pork injection, solution
FOOD - DAIRY PRODUCTS, CASEIN, COW MILK
-
casein injection, solution
FOOD - DAIRY PRODUCTS, MILK, WHOLE COW
-
cow milk injection, solution
FOOD - FISH AND SHELLFISH, CLAM
-
quahog injection, solution
FOOD - FISH AND SHELLFISH, CODFISH GADUS CALLARIAS
-
cod injection, solution
FOOD - FISH AND SHELLFISH, CRAB XIPHOSURUS SOWERBYI
-
crab leg injection, solution
FOOD - FISH AND SHELLFISH, LOBSTER HOMARUS AMERICANUS
-
lobster injection, solution
FOOD - FISH AND SHELLFISH, SALMON SALMO SALAR
-
salmon injection, solution
FOOD - FISH AND SHELLFISH, SHRIMP CRAGO SP.
-
shrimp injection, solution
FOOD - FISH AND SHELLFISH, TUNA THUNNUS SP.
-
tuna injection, solution
FOOD - PLANT SOURCE, ALMOND PRUNUS AMYGDALUS
-
almond injection, solution
FOOD - PLANT SOURCE, APPLE MALUS SP.
-
apple injection, solution
FOOD - PLANT SOURCE, BANANA MUSA SAPIENTUM
-
banana injection, solution
FOOD - PLANT SOURCE, BRAZIL NUT BERTHOLLETIA EXCELSA
-
brazil nut injection, solution
FOOD - PLANT SOURCE, CARROT DAUCUS CAROTA
-
carrot injection, solution
FOOD - PLANT SOURCE, CASHEW NUT ANACARDIUM OCCIDENTALIE
-
cashew injection, solution
FOOD - PLANT SOURCE, CELERY APIUM GRAVEOLENS
-
celery injection, solution
FOOD - PLANT SOURCE, CORN ZEA MAYS
-
corn injection, solution
FOOD - PLANT SOURCE, HAZELNUT (FILBERT) CORYLUS SPP.
-
hazelnut injection, solution
FOOD - PLANT SOURCE, MELON, CANTALOUPE CUCUMIS MELO
-
cantaloupe injection, solution
FOOD - PLANT SOURCE, ORANGE CITRUS SINENSIS
-
orange injection, solution
FOOD - PLANT SOURCE, PEA, GREEN OR ENGLISH PISUM SATIVUM
-
pea injection, solution
FOOD - PLANT SOURCE, PEACH PRUNUS PERSICA
-
peach injection, solution
FOOD - PLANT SOURCE, PEANUT ARACHIS HYPOGAEA
-
peanut injection, solution
FOOD - PLANT SOURCE, PECAN CARYA ILLINOENSIS
-
pecan injection, solution
FOOD - PLANT SOURCE, POTATO, WHITE SOLANUM TUBEROSUM
-
potato injection, solution
FOOD - PLANT SOURCE, RICE, WHOLE GRAIN
-
rice injection, solution
FOOD - PLANT SOURCE, RYE GRAIN
-
rye injection, solution
FOOD - PLANT SOURCE, SOYBEAN GLYCINE SOJA
-
soybean injection, solution
FOOD - PLANT SOURCE, STRAWBERRY FRAGARIA CHILOENSIS
-
strawberry injection, solution
FOOD - PLANT SOURCE, STRING BEAN MIX
-
string bean injection, solution
FOOD - PLANT SOURCE, TOMATO NICOTIANA SPP.
-
tomato injection, solution
FOOD - PLANT SOURCE, WALNUT, BLACK JUGLANS NIGRA
-
black walnut injection, solution
FOOD - PLANT SOURCE, YEAST, BAKER SACCHAROMYCES CEREVISIAE
-
yeast injection, solution
FOOD - PLANT SOURCE, YEAST, BREWER SACCHAROMYCES CEREVISIAE
-
yeast injection, solution
INSECTS (WHOLE BODY) COCKROACH MIX
-
periplaneta americana and
blatella germanica injection, solution
INSECTS (WHOLE BODY), ANT, FIRE SOLENOPSIS INVICTA
-
solenopsis invicta injection, solution
INSECTS (WHOLE BODY), ANT, FIRE SOLENOPSIS RICHTERI
-
solenopsis richteri injection, solution
INSECTS (WHOLE BODY), FIRE ANT MIX
-
solenopsis richteri and
solenopsis invicta injection, solution
MOLDS - ALTERNARIA/HORMODENDRUM MIX
-
alternaria alternata and
cladosporium cladosporioides injection, solution
MOLDS - MOLD MIX 10
-
alternaria alternata,
aspergillus fumigatus,
emericella nidulans,
aspergillus niger var. niger,
aspergillus terreus,
fusarium oxysporum vasinfectum,
dendryphiella vinosa,
cladosporium cladosporioides,
mucor racemosus,
penicillium digitatum,
penicillium expansum,
penicillium chrysogenum var. chrysogenum,
clonostachys rosea f. rosea,
phoma exigua var. exigua,
aureobasidium pullulans var. pullutans and
rhizopus stolonifer injection, solution
MOLDS - MOLD MIX 4
-
alternaria alternata,
aspergillus fumigatus,
emericella nidulans,
aspergillus niger var. niger,
aspergillus terreus,
cladosporium cladosporioides,
penicillium digitatum,
penicillium expansum,
penicillium chrysogenum var. chrysogenum and
clonostachys rosea f. rosea injection, solution
MOLDS - TRICHOPHYTON MIX
-
trichophyton tonsurans,
trichophyton rubrum and
trichophyton mentagrophytes injection, solution
MOLDS, PENICILLIUM MIX
-
penicillium digitatum,
penicillium expansum,
penicillium chrysogenum var. chrysogenum and
clonostachys rosea f. rosea injection, solution
MOLDS, RUSTS AND SMUTS, ALTERNARIA TENUIS
-
alternaria alternata injection, solution
MOLDS, RUSTS AND SMUTS, ASPERGILLUS FUMIGATUS
-
aspergillus fumigatus injection, solution
MOLDS, RUSTS AND SMUTS, ASPERGILLUS NIGER
-
aspergillus niger var. niger injection, solution
MOLDS, RUSTS AND SMUTS, BOTRYTIS CINEREA
-
botrytis cinerea injection, solution
MOLDS, RUSTS AND SMUTS, CANDIDA ALBICANS
-
candida albicans injection, solution
MOLDS, RUSTS AND SMUTS, CEPHALOSPORIUM ACREMONIUM
-
acremonium strictum injection, solution
MOLDS, RUSTS AND SMUTS, CURVULARIA SPICIFERA
-
cochliobolus spicifer injection, solution
MOLDS, RUSTS AND SMUTS, EPICOCCUM NIGRUM
-
epicoccum nigrum injection, solution
MOLDS, RUSTS AND SMUTS, EPIDERMOPHYTON FLOCCOSUM
-
epidermophyton floccosum injection, solution
MOLDS, RUSTS AND SMUTS, FUSARIUM VASINFECTUM
-
fusarium oxysporum vasinfectum injection, solution
MOLDS, RUSTS AND SMUTS, HELMINTHOSPORIUM INTERSEMINATUM
-
dendryphiella vinosa injection, solution
MOLDS, RUSTS AND SMUTS, HORMODENDRUM CLADOSPORIOIDES
-
cladosporium cladosporioides injection, solution
MOLDS, RUSTS AND SMUTS, MUCOR RACEMOSUS
-
mucor racemosus injection, solution
MOLDS, RUSTS AND SMUTS, PENICILLIUM NOTATUM
-
penicillium chrysogenum var. chrysogenum injection, solution
MOLDS, RUSTS AND SMUTS, PHOMA HERBARUM
-
phoma exigua var. exigua injection, solution
MOLDS, RUSTS AND SMUTS, PULLULARIA PULLULANS
-
aureobasidium pullulans var. pullutans injection, solution
MOLDS, RUSTS AND SMUTS, RHIZOPUS NIGRICANS
-
rhizopus stolonifer injection, solution
MOLDS, RUSTS AND SMUTS, STEMPHYLIUM BOTRYOSUM
-
pleospora tarda injection, solution
POLLENS - GRASSES, BAHIA GRASS PASPALUM NOTATUM
-
paspalum notatum pollen injection, solution
POLLENS - GRASSES, BROME, SMOOTH BROMUS INERMIS
-
bromus inermis pollen injection, solution
POLLENS - GRASSES, CORN, CULTIVATED ZEA MAYS
-
zea mays pollen injection, solution
POLLENS - GRASSES, JOHNSON GRASS SORGHUM HALEPENSE
-
sorghum halepense pollen injection, solution
POLLENS - GRASSES, OATS, COMMON, CULTIVATED AVENA SATIVA
-
avena sativa pollen injection, solution
POLLENS - GRASSES, SOUTHERN GRASS MIX
-
poa pratensis pollen,
dactylis glomerata pollen,
agrostis gigantea pollen,
phleum pratense pollen,
anthoxanthum odoratum pollen,
sorghum halepense pollen and
cynodon dactylon pollen injection, solution
POLLENS - GRASSES, SOUTHERN GRASS MIX 10TH OF CONCENTRATE
-
poa pratensis pollen,
dactylis glomerata pollen,
agrostis gigantea pollen,
phleum pratense pollen,
anthoxanthum odoratum pollen,
sorghum halepense pollen and
cynodon dactylon pollen injection, solution
POLLENS - TREES, ACACIA ACACIA LONGIFOLIA
-
acacia longifolia pollen injection, solution
POLLENS - TREES, ALDER, RED ALNUS RUBRA
-
alnus rubra pollen injection, solution
POLLENS - TREES, ASH, WHITE FRAXINUS AMERICANA
-
fraxinus americana pollen injection, solution
POLLENS - TREES, BEECH, AMERICAN FAGUS GRANDIFOLIA
-
fagus grandifolia pollen injection, solution
POLLENS - TREES, BIRCH MIX
-
betula papyrifera pollen,
betula pendula pollen and
betula nigra pollen injection, solution
POLLENS - TREES, BOTTLEBRUSH, CALLISTEMON SPP.
-
callistemon citrinus pollen injection, solution
POLLENS - TREES, BOXELDER/MAPLE MIX
-
acer negundo pollen,
acer saccharum pollen and
acer rubrum pollen injection, solution
POLLENS - TREES, CEDAR, MOUNTAIN JUNIPERUS ASHEI
-
juniperus ashei pollen injection, solution
POLLENS - TREES, CEDAR, RED JUNIPERUS VIRGINIANA
-
juniperus virginiana pollen injection, solution
POLLENS - TREES, COTTONWOOD, COMMON POPULUS DELTOIDES
-
populus deltoides pollen injection, solution
POLLENS - TREES, CYPRESS, ARIZONA CUPRESSUS ARIZONICA
-
cupressus arizonica pollen injection, solution
POLLENS - TREES, CYPRESS, BALD TAXODIUM DISTICHUM
-
taxodium distichum pollen injection, solution
POLLENS - TREES, ELM, AMERICAN ULMUS AMERICANA
-
ulmus americana pollen injection, solution
POLLENS - TREES, ELM, CHINESE ULMUS PARVIFOLIA
-
ulmus parvifolia pollen injection, solution
POLLENS - TREES, EUCALYPTUS (BLUE GUM) EUCALYPTUS GLOBULUS
-
eucalyptus globulus pollen injection, solution
POLLENS - TREES, GUM, SWEET LIQUIDAMBAR STYRACIFLUA
-
liquidambar styraciflua pollen injection, solution
POLLENS - TREES, HACKBERRY CELTIS OCCIDENTALIS
-
celtis occidentalis pollen injection, solution
POLLENS - TREES, HICKORY, SHAGBARK CARYA OVATA
-
carya ovata pollen injection, solution
POLLENS - TREES, LINDEN (BASSWOOD) TILIA AMERICANA
-
tilia americana pollen injection, solution
POLLENS - TREES, MAPLE, HARD ACER SACCHARUM
-
acer saccharum pollen injection, solution
POLLENS - TREES, MELALEUCA (PUNK TREE) MELALEUCA QUINQUENERVIA
-
melaleuca quinquenervia pollen injection, solution
POLLENS - TREES, MESQUITE, PROSOPIS JULIFLORA
-
prosopis juliflora pollen injection, solution
POLLENS - TREES, MULBERRY MIX
-
morus alba pollen and
morus rubra pollen injection, solution
POLLENS - TREES, OAK MIX
-
quercus rubra pollen,
quercus virginiana pollen and
quercus alba pollen injection, solution
POLLENS - TREES, OAK, RED QUERCUS RUBRA
-
quercus rubra pollen injection, solution
POLLENS - TREES, OLIVE OLEA EUROPAEA
-
olea europaea pollen injection, solution
POLLENS - TREES, OLIVE, RUSSIAN ELAEAGNUS ANGUSTIFOLIA
-
elaeagnus angustifolia pollen injection, solution
POLLENS - TREES, PALM, QUEEN COCOS PLUMOSA
-
syagrus romanzoffiana pollen injection, solution
POLLENS - TREES, PALO VERDE CERCIDIUM FLORIDUM
-
cercidium floridum ssp. floridum pollen injection, solution
POLLENS - TREES, PECAN CARYA CARYA ILLINOENSIS
-
carya illinoinensis pollen injection, solution
POLLENS - TREES, PEPPER TREE, CALIFORNIA SCHINUS MOLLE
-
schinus molle pollen injection, solution
POLLENS - TREES, PINE MIX
-
pinus contorta pollen and
pinus ponderosa pollen injection, solution
POLLENS - TREES, PRIVET LIGUSTRUM VULGARE
-
ligustrum vulgare pollen injection, solution
POLLENS - TREES, SYCAMORE, AMERICAN (EASTERN) PLATANUS OCCIDENTALLIS
-
platanus occidentalis pollen injection, solution
POLLENS - TREES, TREE MIX 11
-
fraxinus americana pollen,
fagus grandifolia pollen,
betula nigra pollen,
juglans nigra pollen,
populus deltoides pollen,
ulmus americana pollen,
carya ovata pollen,
acer saccharum pollen,
quercus rubra pollen,
platanus occidentalis pollen and
salix nigra pollen injection, solution
POLLENS - TREES, TREE MIX 5
-
carya illinoinensis pollen,
acer saccharum pollen,
acer negundo pollen,
acer rubrum pollen,
quercus rubra pollen,
quercus virginiana pollen,
quercus alba pollen,
platanus occidentalis pollen and
salix nigra pollen injection, solution
POLLENS - TREES, TREE MIX 6
-
fraxinus americana pollen,
fagus grandifolia pollen,
betula papyrifera pollen,
betula nigra pollen,
betula pendula pollen,
juglans nigra pollen,
populus deltoides pollen and
ulmus americana pollen injection, solution
POLLENS - TREES, TREE OF HEAVEN AILANTHUS ALTISSIMA
-
ailanthus altissima pollen injection, solution
POLLENS - TREES, WALNUT, BLACK JUGLANS NIGRA
-
juglans nigra pollen injection, solution
POLLENS - TREES, WILLOW, BLACK SALIX NIGRA
-
salix nigra pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, COCKLEBUR XANTHIUM STRUMARIUM
-
xanthium strumarium pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, DOG FENNEL EUPATORIUM CAPILLIFOLIUM
-
eupatorium capillifolium pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, GOLDENROD SOLIDAGO CANADENSIS
-
solidago canadensis pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, LAMB QUARTERS CHENOPODIUM ALBUM
-
chenopodium album pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, NETTLE URTICA DIOICA
-
urtica dioica pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, PIGWEED, ROUGH REDROOT AMARANTHUS RETROFLEXUS
-
amaranthus retroflexus pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, PLANTAIN, ENGLISH PLANTAGO LANCEOLATA
-
plantago lanceolata pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, RAGWEED, GIANT AMBROSIA TRIFIDA
-
ambrosia trifida pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, RAGWEED. WESTERN AMBROSIA PSILOSTACHYA
-
ambrosia psilostachya pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, RUSSIAN THISTLE SALSOLA KALI
-
salsola kali pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, SAGEBRUSH, MUGWORT ARTEMISIA VULGARIS
-
artemisia vulgaris pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, SCALE, WING (SHAD) ATRIPLEX CANESCENS
-
atriplex canescens pollen injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, SCOTCH BROOM CYTISUS SCOPARIUS
-
cytisus scoparius flowering top injection, solution
POLLENS - WEEDS AND GARDEN PLANTS, SORREL, SHEEP RUMEX ACETOSELLA
-
rumex acetosella pollen injection, solution
POLLENS - WEEDS, CARELESS WEED AMARANTHUS PALMERI
-
amaranthus palmeri pollen injection, solution
POLLENS - WEEDS, CARELESS/PIGWEED MIX
-
amaranthus palmeri pollen and
amaranthus retroflexus pollen injection, solution
POLLENS - WEEDS, DOCK/SORREL MIX
-
rumex crispus pollen and
rumex acetosella pollen injection, solution
POLLENS - WEEDS, GIANT, SHORT, WESTERN RAGWEED MIX
-
ambrosia trifida pollen,
ambrosia artemisiifolia pollen and
ambrosia psilostachya pollen injection, solution
POLLENS - WEEDS, KOCHIA SCOPARIA
-
kochia scoparia pollen injection, solution
POLLENS - WEEDS, MARSHELDER/POVERTY MIX
-
iva axillaris pollen,
iva annua var. annua pollen and
iva xanthifolia pollen injection, solution
POLLENS - WEEDS, WEED MIX 2630
-
xanthium strumarium pollen,
chenopodium album pollen,
amaranthus retroflexus pollen,
rumex crispus pollen and
rumex acetosella pollen injection, solution
Hollister-Stier Laboratories LLC
----------
INSTRUCTIONS ALLERGENIC EXTRACTS FOR SCRATCH, PRICK OR PUNCTURE TESTING
WARNINGS
This product is intended for use only by physicians who are experienced in the use of allergenic extracts, or for use under the guidance of an allergist. Allergenic extracts may potentially elicit a severe life threatening systemic reaction, rarely resulting in death.7 Therefore, emergency measures and personnel trained in their use must be available immediately in the event of such a reaction. Patients should be instructed to recognize adverse reaction symptoms and cautioned to contact the physician's office if symptoms occur. Patients on non-selective beta blockers may be more reactive to allergens given for testing or treatment and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. This product should never be injected intravenously. Refer also to the WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS Sections for further discussion.
DESCRIPTION
Sterile extracts for scratch, prick or puncture testing are supplied in dropper vials containing, in addition to the extract allergens and antigens, 50% (v/v) glycerin as preservative, 0.5% sodium chloride and 0.275% sodium bicarbonate. The strength of these extracts may be expressed in terms of
- Weight to Volume (w/v)
- Protein Nitrogen Units/mL (PNU/mL)
- Allergy Units/mL (AU/mL)
- Bioequivalent Allergy Units/mL (BAU/mL)
- Concentrate
1. Weight to volume (w/v).
For regular extracts this describes the extraction ratio, i.e., the amount of crude allergen added to the extracting fluid. A 1:10 extract, therefore, indicates that the solution contains the extracted material from one gram of raw material added to each 10 mL of extracting fluid. The amount and composition of extracted materials will vary with the kind of antigen, the extracting fluid, duration of extraction, pH, temperature, and other variables. AP™ (acetone precipitated) extracts, if present, are prepared by reconstituting dry, allergenically active concentrates produced by precipitation process from extracts of raw materials. For those AP™ extracts labeled on a weight per volume (w/v) basis, the strength designation indicates the dry weight of finished (acetone) precipitate per volume of reconstituting fluid. For example, 1:50 (w/v) means that each gram of dry precipitate obtained from the original extract is reconstituted in 50 mL of solution.
2. Protein Nitrogen Units per mL (PNU/mL).
One protein nitrogen unit represents 0.00001 mg phosphotungstic acid-precipitable protein nitrogen dissolved in one mL of antigen extract. The PNU content of extracts of the same antigen may vary according to the method of measuring the PNU. Thus, the PNU content of extracts from different manufacturers is not comparable unless the PNU method is known to be the same and reproducible from lot to lot. Also, the amount of protein nitrogen extracted from an antigen is influenced by the same variables as the weight to volume extract. Allergenic materials make up a variable proportion of the total protein of an extract.
3. Allergy Units per mL (AU/mL).
The potency of extracts labeled in Allergy Units per mL (AU/mL) is determined by in vitro comparison to a reference standard established by the Center for Biologics Evaluation and Research (CBER) of the Food and Drug Administration (FDA).
4. Bioequivalent Allergy Units per mL (BAU/mL).
When originally licensed, the Reference Preparations for standardized extracts were arbitrarily assigned 100,000 Allergy Units (AU)/mL. Subsequently, quantitative skin testing by the ID50EAL method 13 was used to determine that some Reference Preparations should be assigned 10,000 AU/mL, and others 100,000 AU/mL. To avoid possible confusion about this change in the method of allergy unit assignment, the nomenclature is being changed for standardized extracts whose allergy units are assigned based on quantitative skin testing, and such products will be labeled in Bioequivalent Allergy Units (BAU)/mL. References labeled 10,000 BAU/mL can be diluted one to a half million fold, and references labeled 100,000 BAU/mL can be diluted one to 5 million fold and produce a sum of erythema diameter of 50 mm when Intradermal testing highly reactive subjects.
5. Concentrate.
Concentrate label terminology applies to allergenic extract mixtures, where the individual allergens being combined vary in strength or the designation of strength.
CLINICAL PHARMACOLOGY
Allergenic extracts for scratch, prick or puncture testing, used according to the DOSAGE AND ADMINISTRATION section, produce erythema or erythema and wheal reactions in patients with significant IgE-mediated sensitivity to the relevant allergen. This allergic inflammatory response, although not completely understood, is thought to begin with reaction of antigen with IgE on the surface of basophils or mast cells, which initiates a series of biochemical events resulting in the production of histamine and other mediators. These, in turn, produce the immediate-type "wheal and flare" skin reaction.
INDICATIONS & USAGE
Certain diagnostics carry labeling which states Allergenic Extract for Diagnostic Use Only. Data to support the therapeutic use of products labeled with this statement have not been established. 14
In addition to a carefully taken history, the use of glycerin-containing extracts in scratch, prick or puncture testing is an accepted method in the diagnosis of allergic conditions. 1, 2, 3 Extracts of all allergens do not produce equivalent results in scratch, prick or puncture tests. The intensity of the skin reactions produced will be determined by two factors: the degree of sensitivity of the patient, and the nature of the allergenic extract applied.
Scratch, prick or puncture tests are not as sensitive as the intradermal test, but are safer and cause less discomfort. They may, therefore, be the method of choice when a large number of tests are needed, or when testing the pediatric patient. In some cases, where the relatively insensitive scratch, prick or puncture tests are negative or do not confirm the allergic history, follow-up intradermal tests may be positive. However, ANTIGENS PRODUCING LARGE 3 to 4+ SCRATCH, PRICK OR PUNCTURE TESTS SHOULD NOT BE TESTED INTRADERMALLY.
CONTRAINDICATIONS
There are no known absolute contraindications to allergy skin testing. Patients with cardiovascular diseases or pulmonary diseases such as symptomatic asthma, and/or who are receiving cardiovascular drugs such as beta blockers, may be at higher risk for severe adverse reactions. These patients may also be more refractory to the normal anaphylaxis treatment regimen.
WARNINGS
Excessively large local reactions or systemic reactions are more likely to occur if the patient is skin tested shortly after exposure to large amounts of antigen to which s/he is sensitive. Use caution when skin testing patients during a season when pollen is present. Refer to boxed
WARNINGS Section.
PRECAUTIONS
1. General
Always have injectable epinephrine and a tourniquet available when tests are being made. (See ADVERSE REACTION section.) Generally 50 to 60 scratch, prick or puncture tests can be applied safely at one sitting. Patients whose history suggests severe sensitivity should have only 5 to 10 tests applied at a time and these tests applied to the volar surface of one arm. These tests should not all be of the same type of antigen; that is, all grass pollens, all weed pollens, all danders, etc. One or two tests from several classes of antigens should be applied at a time. As soon as a large wheal begins to develop, wipe the antigen from it with a damp cotton sponge. After 10 minutes wipe off all the antigens with a damp cotton sponge, followed by a dry cotton sponge. Be careful not to wipe antigen from a positive reaction onto an adjacent test site.
2 Information for Patients
Patients should be instructed in the recognition of adverse reactions to diagnostic testing. Patients should be made to understand the importance of a 30 minute observation period, and be warned to return to the office promptly if symptoms occur after leaving.
3. Drug Interactions
Patients on non-selective beta blockers may be more reactive to allergens given for testing or treatment and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions.6
Certain medications may lessen the skin test wheal and erythema responses elicited by allergens and histamine for varying time periods. Conventional antihistamines should be discontinued at least 5 days before skin testing. Long acting antihistamines should be discontinued for at least 3 weeks prior to skin testing.9 Topical steroids should be discontinued at the skin test site for at least 2-3 weeks before skin testing.9, 10 Tricyclic antidepressants such as Doxepin should be withheld for at least 7 days before skin testing.11 Topical local anesthetics may suppress the flare responses and should be
avoided in skin test sites.12
4. Carcinogenesis, mutagenesis, Impairment of Fertility
Long-term studies in animals have not been conducted with allergenic extracts to determine their potential for carcinogenicity, mutagenicity or impairment of fertility.
5. Pregnancy
4,5
Pregnancy Category C. Animal reproduction studies have not been conducted with allergenic extracts. It is also not known whether allergenic extracts can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Allergenic extracts should be given to a pregnant woman only if clearly needed.
6. Nursing Mothers
There are no current studies on secretion of the allergenic extract components in human milk or effect on the nursing infant. Because many drugs are excreted in human milk, caution should be exercised when allergenic extracts are administered to a nursing woman.
7. Pediatric Use
Wheal sizes in response to allergen skin testing can be smaller in infants than in adults. The skin response to histamine parallels that for allergens; therefore, appropriate positive control skin tests should always be performed.1
8. Geriatric Use
Skin test wheal size decreases with age. The decrease in allergen-induced skin test reaction parallels that to histamine; therefore, appropriate positive skin test controls should always be performed.1
ADVERSE REACTIONS
1. Local Reactions
If a severe local reaction occurs during scratch, prick or puncture testing, WIPE OFF test antigen. Large, persistent local reactions or minor exacerbations of the patient's allergic symptoms may be treated by local cold applications and/or the use of oral antihistamines, but they should be considered a warning of possible severe systemic reactions.
2. Systemic Reactions
With careful attention to dosage and administration, such reactions occur infrequently, but it must be remembered that allergenic extracts are highly potent in sensitive individuals and OVERDOSE could result in anaphylactic symptoms. Therefore, it is imperative that physicians administering allergenic extracts understand and be prepared for the treatment of severe reactions.
Adverse reaction frequency data for allergenic extract administration for testing and treatment show that risk is low.
7, 8
It cannot be overemphasized that, under certain unpredictable combinations of circumstances, anaphylactic shock is a possibility. Other possible systemic reaction symptoms include fainting, pallor, bradycardia, hypotension, angioedema, cough, wheezing, conjunctivitis, rhinitis and urticaria.
If a systemic or anaphylactic reaction does occur, WIPE OFF test antigen, apply a tourniquet above the site of injection, if tests are performed on the arms, and inject the 1:1,000 epinephrine-hydrochloride intramuscularly or subcutaneously into the opposite arm. Loosen the tourniquet at least every 10 minutes. Do not obstruct arterial blood flow with the tourniquet.
EPINEPHRINE:
ADULT DOSAGE: 0.3 to 0.5 mL should be injected. Repeat in 5 to 10 minutes if necessary.
PEDIATRIC DOSAGE: The usual initial dose is 0.01 mg (mL) per kg body weight or 0.3 mg (mL) per square meter of body surface area. Suggested dosage for infants to 2 years of age is 0.05 mL to 0.1 mL; for children 2 to 6 years, 0.15 mL; and children 6 to 12 years, 0.2 mL. Single pediatric doses should not exceed 0.3 mg (mL). Doses may be repeated as frequently as every 20 minutes, depending on the severity of the condition and the response of the patient. After administration of epinephrine, profound shock or vasomotor collapse should be treated with intravenous fluids, and other appropriate drugs. Oxygen should be given by mask. Intravenous antihistamine, theophylline or corticosteroids may be used if necessary after adequate epinephrine and circulatory support have been given. Emergency resuscitation measures and personnel trained in their use should be available immediately in the event of a serious systemic or anaphylactic reaction not responsive to the above measures (Ref. J. Allergy Clin. Immunol. 77 (2): 271-273, 1986). Rarely are all of the above measures necessary; the tourniquet and epinephrine usually produce prompt responses. However, the physician should be prepared in advance for all contingencies. Promptness in beginning emergency treatment measures is of utmost importance.
OVERDOSAGE
See ADVERSE REACTIONS Section.
DOSAGE & ADMINISTRATION
1. General
Parenteral Drug Products should be inspected visually for particulate matter
and discoloration prior to administration, whenever solution and container
permit.
2. Scratch, Prick or Puncture Testing Methods
There are two general methods of skin testing. (1) The skin is scarified first,
and the extract is then applied. (2) A drop of extract is put onto the skin,
and a prick or puncture is made through the drop. Avoid touching tip of dropper
to skin. Either method is satisfactory, but the second requires that the
instrument be cleansed between tests or that separate needles be used.
The extracts for scratch, prick or puncture testing are supplied
in dropper vials and should be kept in a rack or box in rows of 10 vials
corresponding to the rows of tests to be applied to the skin.
All skin tests should be validated by appropriate positive
control tests (e.g., histamine) and negative control tests (e.g., Glycerin,
Albumin Saline with Phenol (0.4%), or Buffered Saline with Phenol). The
negative control test should be the same material as is used as a diluting
fluid in the tested extracts. Diluting fluid is used in the same way as an
active test extract.
Test sites should be examined at 15 and 30 minutes. To prevent
excessive absorption, wipe off antigens producing large reactions as soon as
the wheal appears. Record the size of the reaction. Delayed reactions may
rarely occur from tests, so it may be helpful to examine the test sites in 24
hours.
Use of Scarifiers and Spacing. Make
scarifications at least 2.5 cm apart. Use more space between pollen tests to
prevent smearing into adjacent sites. Hold the scarifier between the thumb and
index finger, press the sharp edge of the instrument against the skin and twirl
instrument rapidly. The scratch should disrupt only the outer layers of
epidermis but should not produce immediate oozing of blood. The amount of
pressure needed to produce a satisfactory scratch will vary between patients
according to the thickness or fragility of their skin. Experience will indicate
the proper amount of pressure to exert in making the scratch. If the scarifier
is kept sharp and the scratch made quickly, discomfort to the patient is
minimized.
Use of Prick Test Needles. The skin is
cleaned and single drops of each extract applied to the properly identified
test sites. A small, sterile disposable needle, such as a 1/2-inch 26 gauge
needle (with the bevel up), a bifurcated vaccinating needle, or a Prick
Lancetter™ is inserted through the drop superficially into the skin, the skin lifted
slightly and the needle withdrawn. No bleeding should be produced. After about 1
minute the extract may be wiped away.
3. Most Satisfactory Sites for Testing
Prior to testing, clean the skin area to be tested with ether or alcohol and
allow to dry. Use a sterile instrument for each patient. The back or the volar
surface of the arms are the most satisfactory sites for testing. Skin of the
posterior thighs or abdomen may be used if necessary. Avoid very hairy areas
where possible, since the reactions will be smaller and more difficult to
interpret. The most satisfactory areas of the back are from the posterior
axillary fold to 2.5 cm from the spinal column, and from the top of the scapula
to the lower rib margins. The best areas of the arms are the volar surfaces
from the axilla to 2.5 or 5 cm above the wrist, skipping the anti-cubital
space.
4. Use of Antigen Mixes
The use of complicated mixes of unrelated pollens for testing is not
recommended since in the case of a positive reaction, it does not indicate
which pollen(s) are responsible, and in the case of a negative reaction, it
fails to indicate whether the individual pollens at full concentration would
give a positive reaction.
5. Reading Skin Test Reactions
A positive reaction consists of an urticarial wheal with surrounding erythema
(resembling somewhat a mosquito bite reaction) larger than the control site.
The smallest reaction considered positive is erythema with a central papule at
least 5 mm in diameter. In some instances with no reaction at the control site,
erythema may be considered an indication of sensitivity. In general, the size
of wheal and erythema response correlates directly with the patient’s
sensitivity to that allergen.
Standardized Products
(a) Mites:
The skin test concentration of 30,000 AU/mL in dropper vials is used for
scratch, prick or puncture testing. Puncture tests performed on 12 highly
sensitive subjects showed the following:
Species
| Mean Sum of Wheal ± Std. Dev. (mm)
| Mean Sum of Erythema ± Std. Dev. (mm)
|
D. farinae
| 22.4 ± 10.7
| 82.2 ± 21.7
|
D. pteronyssinus
| 24.0 ± 9.9
| 89.3 ± 24.5 |
The sum of a skin response is the sum of the longest diameter and
the mid-point orthogonal diameter.
(b) Cat Hair and Cat Pelt: The skin test concentration of 10,000
BAU/mL (10-19.9 Fel d 1 Units/mL) in dropper vials is used for prick or
puncture testing. Puncture tests performed on 15 highly sensitive subjects
showed the following:
Product
| Mean Sum of Wheal ± Std. Dev (mm)
| Mean Sum of Erythema ± Std. Dev (mm)
|
Standardized Cat Hair
| 15.1 ± 3.8
| 73.3 ± 14.3
|
Standardized Cat Pelt
| 13.9 ± 4.3
| 67.3 ± 13.3 |
The sum of a skin response is the sum of the longest diameter
and the mid-point orthogonal diameter.
(c) Ragweed pollen (Short Ragweed or Giant and Short Ragweed
Mixture) Antigen E Assayed: Short Ragweed extract at 1:20 w/v in 50% glycerin
containing approximately 100 to 300 units of Antigen E/mL or Giant and Short
Ragweed Mix at 1:20 w/v in 50% glycerin containing approximately 50 to 150
units of Antigen E/mL are usually used for scratch, prick or puncture testing.
Refer to the following table to determine the skin test sensitivity
grade. The corresponding ∑E (sum of the longest diameter and the mid-point
orthogonal diameters of erythema) is also presented.
Grade
| Erythema mm
| Papule or Wheal mm
| Corresponding mm ∑E
|
0
| <5
| <5
| <10
|
± | 5-10
| 5-10
| 10-20
|
1+
| 11-20
| 5-10
| 20-40
|
2+
| 21-30
| 5-10
| 40-60
|
3+
| 31-40
| 10-15 (a)
| 60-80
|
4+
| >40
| >15 (b)
| >80
|
(a) or with pseudopods (b) or with many pseudopods
A positive skin reaction to any allergen must be interpreted in
light of the patient’s history of symptoms, time of the year, known exposures,
and eating habits.
THE SKIN TESTS ARE IN NO WAY A SUBSTITUTE FOR A CAREFUL ALLERGIC HISTORY. THEY
SERVE AS ADDITIONAL INFORMATION TO AID IN IDENTIFYING CAUSATIVE ALLERGENS IN
PATIENTS WITH ALLERGIC DISORDERS.
6. Geriatric Use
The dose is the same in patients of all age groups. Because the wheal size in response to allergen skin testing decreases with age, appropriate histamine positive control skin tests must be performed.1
7. Pediatric Use
The dose is the same in patients of all age groups. Wheal size in response to allergen skin testing can be smaller in infants than in adults. Appropriate histamine positive control skin tests must be performed.1
HOW SUPPLIED
In 5 mL dropper bottles of extract at 1:10 w/v except pollen at 1:20, AP™ extracts at 1:50 w/v, except AP™ Dog Hair-Dander at 1:100 w/v, AP™ House Dust at 20,000 PNU/mL, some mixes as Concentrate, and Standardized products at AU/mL (Mite extracts at 30,000 AU/mL) or BAU/mL (Cat Hair and Pelt extracts at 10,000 BAU/mL) value. Strengths are listed on product labels.
STORAGE
The expiration date of the diagnostic extracts is listed on the container label. The extract should be stored at 2° - 8°C and kept at this temperature range during office use.
LIMITED WARRANTY
A number of factors beyond our control could reduce the efficacy of this product or even result in an ill effect following its use. These include storage and handling of the product after it leaves our hands, diagnosis, dosage, method of administration, and biological differences in individual patients. Because of these factors, it is important that this product be stored properly, and that the directions be followed carefully during use. No warranty, express or implied, including any warranty of merchantability or fitness, is made. Representatives of the Company are not authorized to vary the terms or the contents of any printed labeling, including the package insert, for this product except by printed notice from the Company’s headquarters. The prescriber and user of this product must accept the terms hereof.
REFERENCES
1. Middleton, Elliott, Jr., C.E. Reed and E.F. Ellis (Eds.) Allergy Principles and Practice. Fourth Edition, Vol. 1. C.V. Mosby. 1993.
2. Sheldon, J.M., R.G. Lovell and K.P. Mathews. A Manual of Clinical Allergy. W.B. Saunders. 1967.
3. Tuft, L. and H.L. Mueller. Allergy in Children. W.B. Saunders. 1970.
4. DuBuske, L.M., C.J. Ling and A.L. Sheffer. Special problems regarding allergen immunotherapy. Immunol. Allergy Clin. North Am. (USA). 12(1): 145-175, 1992.
5. Weinstein, A.M., B.D. Dubin, W.K. Podleski, S.L. Spector and R.S. Farr. Asthma and pregnancy. JAMA. 124(11): 1161-1165, 1979.
6. Jacobs, Robert L., Geoffrey W. Rake, Jr., et.al. Potentiated anaphylaxis in patients with drug-induced beta-adrenergic blockade. J. Allergy Clin. Immunol. 68(2): 125-127. August 1981.
7. Lockey, Richard F., Linda M. Benedict, Paul C. Turkeltaub, Samuel C. Bukantz. Fatalities from immunotherapy (IT) and skin testing (ST). J. Allergy Clin. Immunol. 79(4): 660-677, 1987.
8. Turkeltaub, Paul C., MD, and Peter J. Gergen, MD. The risk of adverse reactions from percutaneous prick-puncture allergen skin testing, venipuncture, and body measurements: Data from the second National Health and Nutrition Examination Survey 1976-80 (NHANES II). J. Allergy Clin. Immunol. 84(6): 886-890, Dec. 1989.
9. Pipkorn, Ulf. Pharmacological influence of anti-allergic medication on In Vivo allergen testing. Allergy. 43: 81-86, 1988.
10. Andersson, M. and U. Pipkorn. Inhibition of the dermal immediate allergic reaction through prolonged treatment with topical glucocorticosteroids. J. Allergy Clin. Immunol. 79 (2): 345-349. February 1987.
11. Rao, Kamineni S., et al. Duration of suppressive effect of tricyclic anti-depressants on histamine induced wheal and flare reactions on human skin. J. Allergy Clin. Immunol. 82: 752-757, November 1988.
12. Pipkorn, Ulf, and M. Andersson. Topical dermal anesthesia inhibits the flare but not the wheal response to allergen and histamine in the skin prick test. Clin. Allergy. 17: 307-311, 1987.
13. Turkeltaub, Paul C., Suresh, C. Rastogi, Harold Baer. Office of Biologics Research and Review skin test method for evaluation of subject sensitivity to standardized allergenic extracts and for assignment of allergy units to reference preparations using the ID50EAL method (Intradermal Dilution for 50 mm Sum of Erythema Determines the Allergy Unit). Methods of the Allergenic Products Branch Office of Biologics Research and Review, FDA, Bethesda, MD 20892. Revised May 9, 1986.
14. Food and Drug Administration. Biological products; Allergenic extracts classified in Category IIIB; Final order; Revocation of licenses. Federal Register. 59(220): 59228ff. November 16, 1994.
ANIMAL ALLERGENS, AP HORSE HAIR AND DANDER
ap horse hair and dander
injection, solution |
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ANIMAL ALLERGENS, AP CATTLE HAIR AND DANDER
cattle hair and dander
injection, solution |
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ANIMAL ALLERGENS, AP DOG HAIR AND DANDER CANIS SPP
animal allergens, dog dander canis spp
injection, solution |
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ANIMAL ALLERGENS, DOG HAIR AND DANDER CANIS SPP.
dog hair canis spp.
injection, solution |
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ANIMAL ALLERGENS, FEATHER MIX
feather mix
injection, solution |
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ANIMAL ALLERGENS, GUINEA PIG HAIR AND DANDER
guinea pig hair and dander
injection, solution |
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AP HOUSE DUST MIX
ap house dust mix
injection, solution |
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DUST, HOUSE MIXTURE
dust, house mixture
injection, solution |
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FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, BEEF BOVINE SPP.
beef bovine spp.
injection, solution |
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FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, CHICKEN MEAT GALLUS SP.
chicken meat gallus sp.
injection, solution |
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FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, EGG, WHITE GALLUS SP.
egg, white gallus sp.
injection, solution |
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FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, EGG, YOLK GALLUS SP.
egg, yolk gallus sp.
injection, solution |
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FOOD - ANIMAL PRODUCTS AND POULTRY PRODUCTS, PORK SUS SP.
pork sus sp.
injection, solution |
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FOOD - DAIRY PRODUCTS, CASEIN, COW MILK
casein, cow milk
injection, solution |
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FOOD - DAIRY PRODUCTS, MILK, WHOLE COW
milk, whole cow
injection, solution |
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FOOD - FISH AND SHELLFISH, CLAM
clam
injection, solution |
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FOOD - FISH AND SHELLFISH, CODFISH GADUS CALLARIAS
codfish gadus callarias
injection, solution |
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FOOD - FISH AND SHELLFISH, CRAB XIPHOSURUS SOWERBYI
crab xiphosurus sowerbyi
injection, solution |
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FOOD - FISH AND SHELLFISH, LOBSTER HOMARUS AMERICANUS
lobster homarus americanus
injection, solution |
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FOOD - FISH AND SHELLFISH, SALMON SALMO SALAR
salmon salmo salar
injection, solution |
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FOOD - FISH AND SHELLFISH, SHRIMP CRAGO SP.
shrimp crago sp.
injection, solution |
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FOOD - FISH AND SHELLFISH, TUNA THUNNUS SP.
tuna thunnus sp.
injection, solution |
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FOOD - PLANT SOURCE, ALMOND PRUNUS AMYGDALUS
almond prunus amygdalus
injection, solution |
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FOOD - PLANT SOURCE, APPLE MALUS SP.
apple malus sp.
injection, solution |
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FOOD - PLANT SOURCE, BANANA MUSA SAPIENTUM
banana musa sapientum
injection, solution |
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FOOD - PLANT SOURCE, BRAZIL NUT BERTHOLLETIA EXCELSA
brazil nut bertholletia excelsa
injection, solution |
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FOOD - PLANT SOURCE, CARROT DAUCUS CAROTA
carrot daucus carota
injection, solution |
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FOOD - PLANT SOURCE, CASHEW NUT ANACARDIUM OCCIDENTALIE
cashew nut anacardium occidentalie
injection, solution |
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FOOD - PLANT SOURCE, CELERY APIUM GRAVEOLENS
celery apium graveolens
injection, solution |
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FOOD - PLANT SOURCE, CORN ZEA MAYS
corn zea mays
injection, solution |
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FOOD - PLANT SOURCE, HAZELNUT (FILBERT) CORYLUS SPP.
hazelnut (filbert) corylus spp.
injection, solution |
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FOOD - PLANT SOURCE, MELON, CANTALOUPE CUCUMIS MELO
cantaloupe cucumis melo
injection, solution |
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FOOD - PLANT SOURCE, ORANGE CITRUS SINENSIS
orange citrus sinensis
injection, solution |
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FOOD - PLANT SOURCE, PEA, GREEN OR ENGLISH PISUM SATIVUM
pea, green or english pisum sativum
injection, solution |
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FOOD - PLANT SOURCE, PEACH PRUNUS PERSICA
peach prunus persica
injection, solution |
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FOOD - PLANT SOURCE, PEANUT ARACHIS HYPOGAEA
peanut arachis hypogaea
injection, solution |
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FOOD - PLANT SOURCE, PECAN CARYA ILLINOENSIS
pecan carya illinoensis
injection, solution |
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FOOD - PLANT SOURCE, POTATO, WHITE SOLANUM TUBEROSUM
potato, white solanum tuberosum
injection, solution |
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FOOD - PLANT SOURCE, RICE, WHOLE GRAIN
rice, whole grain
injection, solution |
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FOOD - PLANT SOURCE, RYE GRAIN
rye grain
injection, solution |
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FOOD - PLANT SOURCE, SOYBEAN GLYCINE SOJA
soybean glycine soja
injection, solution |
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FOOD - PLANT SOURCE, STRAWBERRY FRAGARIA CHILOENSIS
strawberry fragaria chiloensis
injection, solution |
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FOOD - PLANT SOURCE, STRING BEAN MIX
string bean mix
injection, solution |
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FOOD - PLANT SOURCE, TOMATO NICOTIANA SPP.
tomato nicotiana spp.
injection, solution |
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FOOD - PLANT SOURCE, WALNUT, BLACK JUGLANS NIGRA
walnut, black juglans nigra
injection, solution |
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FOOD - PLANT SOURCE, YEAST, BAKER SACCHAROMYCES CEREVISIAE
yeast, baker saccharomyces cerevisiae
injection, solution |
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FOOD - PLANT SOURCE, YEAST, BREWER SACCHAROMYCES CEREVISIAE
yeast, brewer saccharomyces cerevisiae
injection, solution |
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INSECTS (WHOLE BODY) COCKROACH MIX
insects (whole body) cockroach mix
injection, solution |
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INSECTS (WHOLE BODY), ANT, FIRE SOLENOPSIS INVICTA
ant, fire solenopsis invicta
injection, solution |
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INSECTS (WHOLE BODY), ANT, FIRE SOLENOPSIS RICHTERI
ant, fire solenopsis richteri
injection, solution |
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INSECTS (WHOLE BODY), FIRE ANT MIX
insects (whole body), fire ant mix
injection, solution |
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MOLDS - ALTERNARIA/HORMODENDRUM MIX
molds - alternaria/hormodendrum mix
injection, solution |
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MOLDS - MOLD MIX 10
molds - mold mix 10
injection, solution |
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MOLDS - MOLD MIX 4
molds - mold mix 4
injection, solution |
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MOLDS - TRICHOPHYTON MIX
molds - trichophyton mix
injection, solution |
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MOLDS, PENICILLIUM MIX
molds, penicillium mix
injection, solution |
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MOLDS, RUSTS AND SMUTS, ALTERNARIA TENUIS
alternaria tenuis
injection, solution |
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MOLDS, RUSTS AND SMUTS, ASPERGILLUS FUMIGATUS
aspergillus fumigatus
injection, solution |
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MOLDS, RUSTS AND SMUTS, ASPERGILLUS NIGER
aspergillus niger
injection, solution |
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MOLDS, RUSTS AND SMUTS, BOTRYTIS CINEREA
botrytis cinerea
injection, solution |
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MOLDS, RUSTS AND SMUTS, CANDIDA ALBICANS
candida albicans
injection, solution |
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MOLDS, RUSTS AND SMUTS, CEPHALOSPORIUM ACREMONIUM
cephalosporium acremonium
injection, solution |
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MOLDS, RUSTS AND SMUTS, CURVULARIA SPICIFERA
curvularia spicifera
injection, solution |
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MOLDS, RUSTS AND SMUTS, EPICOCCUM NIGRUM
epicoccum nigrum
injection, solution |
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MOLDS, RUSTS AND SMUTS, EPIDERMOPHYTON FLOCCOSUM
epidermophyton floccosum
injection, solution |
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MOLDS, RUSTS AND SMUTS, FUSARIUM VASINFECTUM
fusarium vasinfectum
injection, solution |
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MOLDS, RUSTS AND SMUTS, HELMINTHOSPORIUM INTERSEMINATUM
helminthosporium interseminatum
injection, solution |
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MOLDS, RUSTS AND SMUTS, HORMODENDRUM CLADOSPORIOIDES
hormodendrum cladosporioides
injection, solution |
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MOLDS, RUSTS AND SMUTS, MUCOR RACEMOSUS
mucor racemosus
injection, solution |
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MOLDS, RUSTS AND SMUTS, PENICILLIUM NOTATUM
penicillium notatum
injection, solution |
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MOLDS, RUSTS AND SMUTS, PHOMA HERBARUM
phoma herbarum
injection, solution |
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MOLDS, RUSTS AND SMUTS, PULLULARIA PULLULANS
pullularia pullulans
injection, solution |
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MOLDS, RUSTS AND SMUTS, RHIZOPUS NIGRICANS
rhizopus nigricans
injection, solution |
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MOLDS, RUSTS AND SMUTS, STEMPHYLIUM BOTRYOSUM
stemphylium botryosum
injection, solution |
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POLLENS - GRASSES, BAHIA GRASS PASPALUM NOTATUM
bahia grass paspalum notatum
injection, solution |
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POLLENS - GRASSES, BROME, SMOOTH BROMUS INERMIS
brome, smooth bromus inermis
injection, solution |
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POLLENS - GRASSES, CORN, CULTIVATED ZEA MAYS
corn, cultivated zea mays
injection, solution |
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POLLENS - GRASSES, JOHNSON GRASS SORGHUM HALEPENSE
johnson grass sorghum halepense
injection, solution |
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POLLENS - GRASSES, OATS, COMMON, CULTIVATED AVENA SATIVA
oats, common, cultivated avena sativa
injection, solution |
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POLLENS - GRASSES, SOUTHERN GRASS MIX
pollens - grasses, southern grass mix
injection, solution |
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POLLENS - GRASSES, SOUTHERN GRASS MIX 10TH OF CONCENTRATE
pollens - grasses, southern grass mix
injection, solution |
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POLLENS - TREES, ACACIA ACACIA LONGIFOLIA
acacia longifolia
injection, solution |
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POLLENS - TREES, ALDER, RED ALNUS RUBRA
alder, red alnus rubra
injection, solution |
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POLLENS - TREES, ASH, WHITE FRAXINUS AMERICANA
ash, white fraxinus americana
injection, solution |
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POLLENS - TREES, BEECH, AMERICAN FAGUS GRANDIFOLIA
beech, american fagus grandifolia
injection, solution |
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POLLENS - TREES, BIRCH MIX
birch mix
injection, solution |
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POLLENS - TREES, BOTTLEBRUSH, CALLISTEMON SPP.
bottlebrush, callistemon citrinus
injection, solution |
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POLLENS - TREES, BOXELDER/MAPLE MIX
boxelder/maple mix
injection, solution |
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POLLENS - TREES, CEDAR, MOUNTAIN JUNIPERUS ASHEI
cedar, mountain juniperus ashei
injection, solution |
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POLLENS - TREES, CEDAR, RED JUNIPERUS VIRGINIANA
cedar, red juniperus virginiana
injection, solution |
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POLLENS - TREES, COTTONWOOD, COMMON POPULUS DELTOIDES
cottonwood, common populus deltoides
injection, solution |
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POLLENS - TREES, CYPRESS, ARIZONA CUPRESSUS ARIZONICA
cypress, arizona cupressus arizonica
injection, solution |
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POLLENS - TREES, CYPRESS, BALD TAXODIUM DISTICHUM
cypress, bald taxodium distichum
injection, solution |
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POLLENS - TREES, ELM, AMERICAN ULMUS AMERICANA
elm, american ulmus americana
injection, solution |
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POLLENS - TREES, ELM, CHINESE ULMUS PARVIFOLIA
elm, chinese ulmus parvifolia
injection, solution |
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POLLENS - TREES, EUCALYPTUS (BLUE GUM) EUCALYPTUS GLOBULUS
eucalyptus (blue gum) eucalyptus globulus
injection, solution |
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POLLENS - TREES, GUM, SWEET LIQUIDAMBAR STYRACIFLUA
gum, sweet liquidambar styraciflua
injection, solution |
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POLLENS - TREES, HACKBERRY CELTIS OCCIDENTALIS
hackberry celtis occidentalis
injection, solution |
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POLLENS - TREES, HICKORY, SHAGBARK CARYA OVATA
hickory, shagbark carya ovata
injection, solution |
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POLLENS - TREES, LINDEN (BASSWOOD) TILIA AMERICANA
linden (basswood) tilia americana
injection, solution |
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POLLENS - TREES, MAPLE, HARD ACER SACCHARUM
maple, hard acer saccharum
injection, solution |
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POLLENS - TREES, MELALEUCA (PUNK TREE) MELALEUCA QUINQUENERVIA
melaleuca, melaleuca quinquenervia
injection, solution |
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POLLENS - TREES, MESQUITE, PROSOPIS JULIFLORA
mesquite, prosopis juliflora
injection, solution |
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POLLENS - TREES, MULBERRY MIX
mulberry mix
injection, solution |
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POLLENS - TREES, OAK MIX
oak mix
injection, solution |
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POLLENS - TREES, OAK, RED QUERCUS RUBRA
oak, red quercus rubra
injection, solution |
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POLLENS - TREES, OLIVE OLEA EUROPAEA
olive olea europaea
injection, solution |
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POLLENS - TREES, OLIVE, RUSSIAN ELAEAGNUS ANGUSTIFOLIA
russian olive elaeagnus angustifolia
injection, solution |
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POLLENS - TREES, PALM, QUEEN COCOS PLUMOSA
palm, queen cocos plumosa
injection, solution |
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POLLENS - TREES, PALO VERDE CERCIDIUM FLORIDUM
palo verde cercidium floridum
injection, solution |
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POLLENS - TREES, PECAN CARYA CARYA ILLINOENSIS
pecan carya carya illinoensis
injection, solution |
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POLLENS - TREES, PEPPER TREE, CALIFORNIA SCHINUS MOLLE
pepper tree, california schinus molle
injection, solution |
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POLLENS - TREES, PINE MIX
pine mix
injection, solution |
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POLLENS - TREES, PRIVET LIGUSTRUM VULGARE
privet ligustrum vulgare
injection, solution |
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POLLENS - TREES, SYCAMORE, AMERICAN (EASTERN) PLATANUS OCCIDENTALLIS
sycamore, american (eastern) platanus occidentallis
injection, solution |
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POLLENS - TREES, TREE MIX 11
tree mix 11
injection, solution |
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POLLENS - TREES, TREE MIX 5
tree mix 5
injection, solution |
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POLLENS - TREES, TREE MIX 6
tree mix 6
injection, solution |
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POLLENS - TREES, TREE OF HEAVEN AILANTHUS ALTISSIMA
tree of heaven ailanthus altissima
injection, solution |
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POLLENS - TREES, WALNUT, BLACK JUGLANS NIGRA
walnut, black juglans nigra
injection, solution |
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POLLENS - TREES, WILLOW, BLACK SALIX NIGRA
willow, black salix nigra
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, COCKLEBUR XANTHIUM STRUMARIUM
cocklebur xanthium strumarium
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, DOG FENNEL EUPATORIUM CAPILLIFOLIUM
dog fennel eupatorium capillifolium
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, GOLDENROD SOLIDAGO CANADENSIS
goldenrod solidago canadensis
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, LAMB QUARTERS CHENOPODIUM ALBUM
lamb quarters chenopodium album
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, NETTLE URTICA DIOICA
nettle urtica dioica
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, PIGWEED, ROUGH REDROOT AMARANTHUS RETROFLEXUS
pigweed, rough redroot amaranthus retroflexus
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, PLANTAIN, ENGLISH PLANTAGO LANCEOLATA
plantain, english plantago lanceolata
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, RAGWEED, GIANT AMBROSIA TRIFIDA
ragweed, giant ambrosia trifida
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, RAGWEED. WESTERN AMBROSIA PSILOSTACHYA
ragweed. western ambrosia psilostachya
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, RUSSIAN THISTLE SALSOLA KALI
russian thistle salsola kali
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, SAGEBRUSH, MUGWORT ARTEMISIA VULGARIS
sagebrush, mugwort artemisia vulgaris
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, SCALE, WING (SHAD) ATRIPLEX CANESCENS
scale, wing (shad) atriplex canescens
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, SCOTCH BROOM CYTISUS SCOPARIUS
scotch broom cytisus scoparius
injection, solution |
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POLLENS - WEEDS AND GARDEN PLANTS, SORREL, SHEEP RUMEX ACETOSELLA
sorrel, sheep rumex acetosella
injection, solution |
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POLLENS - WEEDS, CARELESS WEED AMARANTHUS PALMERI
careless weed amaranthus palmeri
injection, solution |
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POLLENS - WEEDS, CARELESS/PIGWEED MIX
careless/pigweed mix
injection, solution |
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POLLENS - WEEDS, DOCK/SORREL MIX
pollens - weeds, dock/sorrel mix
injection, solution |
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POLLENS - WEEDS, GIANT, SHORT, WESTERN RAGWEED MIX
giant, short, western ragweed mix
injection, solution |
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POLLENS - WEEDS, KOCHIA SCOPARIA
kochia scoparia
injection, solution |
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POLLENS - WEEDS, MARSHELDER/POVERTY MIX
pollens - weeds, marshelder/poverty mix
injection, solution |
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POLLENS - WEEDS, WEED MIX 2630
weed mix 2630
injection, solution |
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Revised: 06/2010Hollister-Stier Laboratories LLC