Rice Food: Package Insert and Label Information (Page 2 of 3)

3 DOSAGE FORMS AND STRENGTHS

Non-Standardized Allergenic Extracts are labeled in weight/volume and/or protein nitrogen units (PNU)/milliliter (a measure of total protein), and are supplied as sterile aqueous stock concentrates at up to 1:10 weight/volume or 40,000 PNU/milliliter, or 50% glycerin stock concentrates at up to 1:20 weight/volume.

4 CONTRAINDICATIONS

Non-Standardized Allergenic Extracts are contraindicated in patients with:

  • Severe, unstable or uncontrolled asthma
  • History of any severe systemic or local allergic reaction to an allergen extract

5 WARNINGS AND PRECAUTIONS

5.1 Serious Systemic Adverse Reactions

Serious systemic adverse reactions have occurred following the administration of other allergenic extracts and may occur in individuals following the administration of Non-Standardized Allergenic Extracts in the following situations:

  • Extreme sensitivity to the specific allergen(s)
  • Receipt of an accelerated immunotherapy build-up schedule (e.g., “rush” immunotherapy)
  • Receipt of high doses of allergenic extracts or concomitant exposure to similar environmental allergens
  • Change from one allergenic extract lot to another allergenic extract lot

High-risk patients have had fatal reactions. Consider using more dilute preparations in patients suspected to be at greater risk of systemic allergic reaction [see Dosage and Administration (2.1)].

Administer Non-Standardized Allergenic Extracts in a healthcare setting under the supervision of a physician prepared to manage a severe systemic or a severe local allergic reaction.Observe patients in the office for at least 30 minutes following administration. 1

5.2 Epinephrine

Non-Standardized Allergenic Extracts may not be suitable for patients with certain medical conditions that may reduce the ability to survive a serious allergic reaction or increase the risk of adverse reactions after epinephrine administration. Examples of these medical conditions include but are not limited to: markedly compromised lung function (either chronic or acute), unstable angina, recent myocardial infarction, significant arrhythmia, and uncontrolled hypertension.

These products may not be suitable for patients who are taking medications that can potentiate or inhibit the effect of epinephrine. These medications include:

Βeta-adrenergic blockers: Patients taking beta-adrenergic blockers may be unresponsive to the usual doses of epinephrine used to treat serious systemic reactions, including anaphylaxis. Specifically, beta-adrenergic blockers antagonize the cardiostimulating and bronchodilating effects of epinephrine.

Alpha-adrenergic blockers, ergot alkaloids: Patients taking alpha-adrenergic blockers may be unresponsive to the usual doses of epinephrine used to treat serious systemic reactions, including anaphylaxis. Specifically, alpha-adrenergic blockers antagonize the vasoconstricting and hypertensive effects of epinephrine. Similarly, ergot alkaloids may reverse the pressor effects of epinephrine.

Tricyclic antidepressants, levothyroxine sodium, monoamine oxidase inhibitors, and certain antihistamines: The adverse effects of epinephrine may be potentiated in patients taking tricyclic antidepressants, levothyroxine sodium, monoamine oxidase inhibitors, and the antihistamines chlorpheniramine, and diphenhydramine.

Cardiac glycosides, diuretics: Patients who receive epinephrine while taking cardiac glycosides or diuretics should be observed carefully for the development of cardiac arrhythmias.

5.3 Cross-Reactions and Dose Sensitivity

When determining the final dose of an allergen mixture for immunotherapy, consider cross-reactivity among component extracts.

Determine the initial dilution of allergenic extract, starting dose, and progression of dosage based on the patient’s history and results of skin tests 2 [see Dosage and Administration (2.1)]. Strongly positive skin tests can be indicators for potential adverse reactions.

6 ADVERSE REACTIONS

The most common adverse reactions, occurring in 26 to 82% of all patients who receive subcutaneous immunotherapy are local adverse reactions at the injection site (e.g., erythema, itching, swelling, tenderness, pain). 1 Systemic adverse reactions, occurring in ≤ 7% of patients who receive subcutaneous immunotherapy, 3 include generalized skin erythema, urticaria, pruritus, angioedema, rhinitis, wheezing, laryngeal edema, and hypotension. These adverse reactions can be fatal. 1

The allergenic extracts labeled “For Diagnostic Use Only” that contain sodium formaldehyde sulfoxylate (SFS) can cause slight discoloration of the skin at the site of administration. This discoloration can remain for extended amounts of time.

7 DRUG INTERACTIONS

7.1 Antihistamines

Do not perform skin testing with allergenic extracts within 3 to 10 days of use of first-generation H1-histamine receptor blockers (e.g., clemastine, diphenhydramine) and second-generation antihistamines (e.g., loratadine, cetirizine). These products suppress histamine skin test reactions and could mask a positive response. 2

7.2 Topical Corticosteroids and Topical Anesthetics

Topical corticosteroids can suppress skin reactivity; therefore, discontinue use at the skin test site for 2 to 3 weeks before skin testing. Avoid use of topical local anesthetics at skin test sites as they can suppress flare responses. 2

7.3 Tricyclic Antidepressants

Tricyclic antidepressants can have potent antihistamine effects that can affect skin testing. If tricyclic medication has been recently discontinued, allow 7 to 14 days before initiating skin testing. 2

8 USE IN SPECIFIC POPULATIONS

8.1 Pregnancy

Risk Summary

All pregnancies have a risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. There are no human or animal data to establish the presence or absence of Non-Standardized Allergenic Extracts-associated risks during pregnancy.

8.2 Lactation

Risk Summary

It is not known whether Non-Standardized Allergenic Extracts are present in human milk. Data are not available to assess the effects of these extracts on the breastfed child or on milk production/excretion. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Non-Standardized Allergenic Extracts and any potential adverse effects on the breastfed child from the extracts or from the underlying maternal condition.

8.4 Pediatric Use

For use of these products in children younger than 5 years of age, consideration should be given to the patient’s ability to comply and cooperate with allergen immunotherapy and the potential for difficulty in communicating with the child regarding systemic reactions. 1

8.5 Geriatric Use

Data are not available to determine if subjects 65 years of age and older respond differently to allergen immunotherapy than younger subjects.

11 DESCRIPTION

Non-Standardized Allergenic Extracts are sterile solutions used for percutaneous testing, intradermal testing, or subcutaneous immunotherapy. Aqueous extracts contain the soluble extractants of the source material in water for injection, 0.5% sodium chloride, 0.54% sodium bicarbonate, and 0.4% phenol. Glycerinated extracts contain the soluable extractants of the source material in water for injection and 50% glycerin, 0.25% sodium chloride, 0.27% sodium bicarbonate, and 0.2% phenol. The pH of the extracts range from 6 to 9.

Certain food extracts (Barley, Oat, Pineapple, Rye, Spinach, and Wheat), labeled “For Diagnostic Use Only”, contain 0.1% sodium formaldehyde sulfoxylate as an antioxidant.

Source materials used in the manufacture of allergenic extracts are collected from natural sources or from laboratory cultures.

Non-Standardized Allergenic Extracts appear as clear and colorless to dark brown solutions that should be free of particulate matter.

Extracts are labeled either as weight-to-volume based on the weight of the source material to the volume of the extracting fluid, or as PNU/milliliter with one PNU representing 0.00001 mg of protein nitrogen per milliliter.

12 CLINICAL PHARMACOLOGY

12.1 Mechanism of Action

The skin test reaction results from interaction of the introduced allergen and allergen-specific IgE antibodies bound to mast cells, leading to mast cell degranulation and release of histamine, tryptase and other mediators, which results in the formation of the wheal and flare.

The precise mechanisms of action of allergen immunotherapy are not known. Immunologic responses to immunotherapy include changes in allergen-specific IgE levels, allergen-specific IgG levels, and regulatory T cell responses. 1

14 CLINICAL STUDIES

Specific immunotherapy with allergenic extracts is helpful in reducing symptoms associated with exposure to the offending allergens. A summary of effectiveness by the Panel on Review of Allergenic Extracts, an advisory committee to the U.S. Food and Drug Administration, has been published. 4

15 REFERENCES

  1. Cox LJ, Nelson H, Lockey R.Allergen immunotherapy: A practice parameter third update. J Allergy Clin Immunol. 2011;127:(1)S1-55.
  2. Bernstein IL, Li JT, Bernstein DI, et al.Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100:S1-148.
  3. Greenberg MA, Kaufman CR, Gonzalez GE, et al. Late and immediate systemic-allergic reactions to inhalant allergen immunotherapy. J Allergy Clin Immunol. 1986;77:865-870.
  4. Federal Register Proposed Rule: Biological Products: Implementation of Efficacy Review, Allergenic Extracts, Federal Register 1985;50: 3082-3288.

16 HOW SUPPLIED/STORAGE AND HANDLING

16.1 How Supplied

Non-Standardized Allergenic Extracts and mixes may be supplied as aqueous stock concentrates of up to 1:10 weight/volume or 40,000 PNU/milliliter for intradermal and subcutaneous testing. The extracts may also be supplied as 50% glycerin stock concentrates of up to 1:20 weight/volume for use in percutaneous skin testing and subcutaneous immunotherapy. Non-Standardized Allergenic Extracts are labeled in weight/volume and/or PNU/milliliter and may be provided in 5, 10, and 50 milliliter vials. Glycerinated extracts are also supplied in 5 milliliter dropper vials for prick or puncture testing.

Non-Standardized Allergenic Extracts available are as follows:

Pollens ‑ Grasses
Bahia Grass, Paspalum notatum
Brome, Smooth, Bromus inermis
Canarygrass, Reed, Phalaris arundinacea
Johnson Grass, Sorghum halepense
Quack (Couch) Grass, Elymus repens
Ryegrass, Giant Wild, Leymus condensatus
Velvetgrass, Holcus lanatus
Wheatgrass, Western, Pascopyrum smithii
Pollens — Trees
Acacia, Acacia dealbata
Alder, Hazel, Alnus serrulata
Alder, Red, Alnus rubra
Alder, White, Alnus rhombifolia
Ash, Arizona (Velvet), Fraxinus velutina
Ash, Green, Fraxinus pennsylvanica
Ash Mix (Equal parts Fraxinus pennsylvanica , Fraxinus americana)
Ash, Oregon, Fraxinus latifolia
Ash, White, Fraxinus americana
Aspen, Populus tremuloides
Beech, American, Fagus grandifolia
Birch, Black-Sweet, Betula lenta
Birch, Mix (Equal parts Betula lenta , Betula nigra , Betula populifolia)
Birch, River, Betula nigra
Birch, Spring, Betula occidentalis
Birch, White, Betula populifolia
Box Elder, Acer negundo
Cedar, Mountain, Juniperus ashei
Cedar, Red, Juniperus virginiana
Cedar, Salt (Tamarisk), Tamarix gallica
Central/Eastern 4 Tree Mix (Equal parts Ulmus americana , Acer negundo , Carya illinoinensis , Quercus virginiana)
Cottonwood, Arizona (Fremont), Populus fremontii
Cottonwood, Black, Populus trichocarpa
Cottonwood, Eastern, Populus deltoides
Cottonwood, Western, Populus deltoides ssp. monilifera
Cypress, Arizona, Callitropsis arizonica
Cypress, Bald, Taxodium distichum
Eastern Oak Mix (Equal parts Quercus velutina , Quercus rubra , Quercus alba)
Eastern 6 Tree Mix (Equal parts Fagus grandifolia , Populus deltoides , Quercus rubra , Betula nigra , Carya ovata , Fraxinus americana)
Eastern 7 Tree Mix (Equal parts Ulmus americana , Fagus grandifolia , Populus deltoides , Quercus rubra , Betula nigra , Carya ovata , Fraxinus americana)
Eastern 8 Tree Mix (Equal parts Ulmus americana , Fagus grandifolia , Populus deltoides , Quercus rubra , Betula nigra , Carya ovata , Fraxinus americana , Acer saccharum)
Eastern 10 Tree Mix (Equal parts Platanus occidentalis , Ulmus americana , Fagus grandifolia , Populus deltoides , Quercus rubra , Betula nigra , Carya ovata , Fraxinus americana , Acer saccharum , Liquidambar styraciflua)
Elm, American, Ulmus americana
Elm, Cedar, Ulmus crassifolia
Elm Mix (Equal parts Ulmus americana , Ulmus pumila)
Elm, Siberian, Ulmus pumila
Eucalyptus, Bluegum, Eucalyptus globulus
Hackberry, Celtis occidentalis
Hazelnut, American, Corylus americana
Hickory Mix (Equal parts Carya glabra , Carya ovata , Carya laciniosa , Carya tomentosa)
Hickory-Pecan Mix (Equal parts Carya illinoinensis , Carya ovata)
Hickory, Shagbark, Carya ovata
Hickory, Shellbark, Carya laciniosa
Hickory, White, Carya tomentosa
Juniper Mix (Equal parts Juniperus monosperma , Juniperus scopulorum)
Juniper, Oneseed, Juniperus monosperma
Juniper, Pinchot, Juniperus pinchotii
Juniper, Rocky Mountain, Juniperus scopulorum
Juniper, Utah, Juniperus osteosperma
Juniper, Western, Juniperus occidentalis
Locust Blossom, Black, Robinia pseudoacacia
Mango Blossom, Mangifera indica
Maple-Box Elder Mix (Equal parts Acer saccharum , Acer negundo)
2 Maple Mix (Equal parts Acer rubrum , Acer saccharum)
3 Maple Mix (Equal parts Acer rubrum , Acer saccharinum , Acer saccharum)
Maple, Red, Acer rubrum
Maple, Silver/Soft, Acer saccharinum
Maple, Sugar/Hard, Acer saccharum
Melaleuca, Melaleuca quinquenervia
Mesquite, Velvet Prosopis velutina
Mulberry, Paper, Broussonetia papyrifera
Mulberry, Red, Morus rubra
Mulberry, White, Morus alba
Oak, Arizona (Gambel), Quercus gambelii
Oak, Black, Quercus velutina
Oak, Bur, Quercus macrocarpa
Oak, California Black, Quercus kelloggii
Oak, California Live, Quercus agrifolia
Oak, California White, Quercus lobata
Oak, Post, Quercus stellata
Oak, Red, Quercus rubra
Oak, Virginia Live, Quercus virginiana
Oak, Water, Quercus nigra
Oak, Western White, Quercus garryana
Oak, White, Quercus alba
Olive, Olea europaea
Olive, Russian, Elaeagnus angustifolia
Orange Pollen, Citrus X sinensis
Palm, Queen, Syagrus romanzoffiana
Pecan, Carya illinoinensis
Peppertree Mix (Equal parts Schinus molle , Schinus terebinthifolius)
Pine, Australian (Beefwood), Casuarina equisetifolia
Pine, Loblolly, Pinus taeda
Pine, Longleaf, Pinus palustris
Pine Mix (Equal parts Pinus taeda , Pinus strobus , Pinus echinata)
Pine, Ponderosa, Pinus ponderosa
Pine, Virginia Scrub, Pinus virginiana
Pine, White (Eastern), Pinus strobus
Pine, White (Western), Pinus monticola
Pine, Yellow, Pinus echinata
Poplar, Lombardy’s, Populus nigra
Poplar, White, Populus alba
Privet, Ligustrum vulgare
Sweetgum, Liquidambar styraciflua
Sycamore, American, Platanus occidentalis
Sycamore, California (Western), Platanus racemosa
11 Tree Mix (Equal parts Fagus grandifolia , Platanus occidentalis , Ulmus americana , Juglans nigra , Salix nigra , Populus deltoides, Quercus rubra , Betula nigra , Carya ovata , Acer saccharum , Fraxinus americana)
Walnut, Black, Juglans nigra
Walnut, California Black, Juglans californica
Walnut, English, Juglans regia
Wax Myrtle, Morella cerifera
Western Oak Mix (Equal parts Quercus kelloggii , Quercus agrifolia , Quercus garryana)
Western 3 Tree Mix (Equal parts Olea europaea , Ulmus pumila , Platanus racemosa)
Western 10 Tree Mix (Equal parts Acacia dealbata , Acer negundo , Populus fremontii , Olea europaea , Ulmus pumila , Betula occidentalis , Juniperus occidentalis , Platanus racemosa , Quercus garryana , Morus alba)
Western Walnut Mix (Equal parts Juglans californica , Juglans regia)
Willow, Arroyo, Salix lasiolepis
Willow, Black, Salix nigra
Pollens — Weeds and Garden Plants
Allscale, Atriplex polycarpa
Amaranth, Green, Amaranthus hybridus
Baccharis Mix (Equal parts Baccharis sarothroides , Baccharis halimifolia)
Burningbush (Kochia), Kochia scoparia spp. scoparia
Burrobrush, Ambrosia salsola
Central/Western Weed Mix (Equal parts Kochia scoparia ssp. scoparia , Chenopodium album , Salsola kali)
Cocklebur, Xanthium strumarium
Common Weed Mix (Equal parts Xanthium strumarium , Plantago lanceolata , Chenopodium album , Amaranthus retroflexus , Salsola kali)
Dock-Sorrel Mix (Equal parts Rumex acetosella , Rumex crispus)
Dock, Yellow (Curly), Rumex crispus
Dogfennel, Eupatorium capillifolium
Goldenrod, Solidago canadensis
Iodinebush, Allenrolfea occidentalis
Lamb’s Quarters, Chenopodium album
Lenscale (Quailbrush), Atriplex lentiformis
Marsh Elder, True (Rough), Iva annua
Marshelder, Burweed (Giant Poverty), Cyclachaena xanthiifolia
Mixed Amaranths (Equal parts Amaranthus hybridus , Amaranthus palmeri , Amaranthus retroflexus)
Mugwort, Common, Artemisia vulgaris
National Weed Mix (Equal parts Xanthium strumarium , Ambrosia trifida , Chenopodium album , Amaranthus retroflexus , Ambrosia artemisiifolia)
Nettle, Urtica dioica
Palmer’s Amaranth, Amaranthus palmeri
Pigweed, Rough Redroot, Amaranthus retroflexus
Pigweed, Spiny, Amaranthus spinosus
Plantain, English, Plantago lanceolata
Plantain-Sorrel Mix (Equal parts Plantago lanceolata , Rumex acetosella)
Rabbit Bush, Ambrosia deltoidea
Ragweed, Desert, Ambrosia dumosa
Ragweed, False, Ambrosia acanthicarpa
Ragweed, Giant (Tall), Ambrosia trifida
Ragweed, Lanceleaf, Ambrosia bidentata
Ragweed, Slender, Ambrosia confertiflora
Ragweed, Western, Ambrosia psilostachya
Russian Thistle, Salsola kali
Sagebrush, Common, Artemisia tridentata
Sage Mix (Equal parts Artemisia tridentata , Artemisia ludoviciana)
Sage, Prairie, Artemisia ludoviciana
Saltbush, Annual, Atriplex wrightii
Scale/Atriplex Mix (Equal parts Atriplex polycarpa , Atriplex lentiformis , Atriplex canescens)
Sorrel, Sheep (Red), Rumex acetosella
Waterhemp, Tall, Amaranthus tuberculatus
3 Weed Mix (Equal parts Xanthium strumarium , Chenopodium album , Amaranthus retroflexus)
Western Ragweed Mix (Equal parts Ambrosia acanthicarpa , Ambrosia psilostachya)
Wingscale, Atriplex canescens
Plants and Plant Parts
Cotton Linters, Gossypium hirsutum
Cottonseed, Gossypium hirsutum (For Diagnostic Use Only)
Flax, Linum usitatissimum (For Diagnostic Use Only)
Gum, Arabic, Acacia senegal
Gum, Karaya, Sterculia urens
Gum, Tragacanth, Astragalus gummifer
Kapok, Ceiba pentandra
Orris Root, Iris germanica
Pyrethrum, Chrysanthemum cinerariifolium
Tobacco, Cultivated, Leaf, Nicotiana tabacum
Pollens — Cultivated Farm Plants
Alfalfa, Medicago sativa
Beet, Sugar, Beta vulgaris
Corn, Cultivated, Zea mays
Oat, Cultivated, Avena sativa
Rape (Mustard), Brassica napus
Red Clover, Trifolium pratense
Rye, Cultivated, Secale cereale
Wheat, Cultivated, Triticum aestivum
Pollens — Flowers
Daisy, Leucanthemum vulgare
Dandelion, Taraxacum officinale
Sunflower, Helianthus annuus
Molds, Rusts and Smuts
AHH Mold Mix (Equal parts Alternaria alternata , Bipolaris sorokiniana , Cladosporium sphaerospermum)
Alternaria alternata
Alternaria/Hormodendrum Mix (Equal parts Alternaria alternata , Cladosporium sphaerospermum)
Aspergillus amstelodami
Aspergillus flavus
Aspergillus fumigatus
Aspergillus Mix (Equal parts Aspergillus amstelodami , Aspergillus flavus , Aspergillus fumigatus , Aspergillus nidulans , Aspergillus niger)
Aspergillus nidulans
Aspergillus niger
Aureobasidium pullulans
Bermuda Grass Smut, Ustilago cynodontis
Bipolaris sorokiniana
Botrytis cinerea
Candida albicans
Chaetomium globosum
Cladosporium herbarum
Cladosporium sphaerospermum
Corn Smut, Ustilago maydis
Curvularia spicifera
Dematiaceae Mix (Equal parts Alternaria alternata , Aureobasidium pullulans , Bipolaris sorokiniana , Cladosporium herbarum , Curvularia spicifera , Helminthosporium solani)
Epicoccum nigrum
Epidermophyton floccosum
Fusarium Mix (Equal parts Gibberella fujikuroi , Fusarium solani)
Fusarium solani
Geotrichum candidum
Gibberella fujikuroi
Gliocladium viride
Grain Smut Mix (Equal parts Ustilago maydis , Ustilago tritici , Ustilago nuda , Ustilago avenae)
Grass Smut Mix (Equal parts Ustilago cynodontis , Sporisorium cruentum)
Helminthosporium solani
Hypomyces perniciousus
Loose Kernel Smut, Sporisorium cruentum
Loose Smut, Wheat, Ustilago tritici
Microsporum canis
Mold Mix #1 (Equal parts Alternaria alternata , Aspergillus niger , Bipolaris sorokiniana , Cladosporium sphaerospermum , Penicillium chrysogenum var. chrysogenum)
Mold Mix #2 (Equal parts Aureobasidium pullulans , Curvularia spicifera , Gibberella fujikuroi , Mucor plumbeus , Rhizopus stolonifer)
Mold Mix #3 (Equal parts Alternaria alternata , Aspergillus niger , Cladosporium sphaerospermum , Penicillium chrysogenum var. chrysogenum)
Monilia Mix (Equal parts Candida albicans , Neurospora intermedia)
Mucor circinelloides f. circinelloides
Mucor circinelloides f. lusitanicus
Mucor Mix (Equal parts Mucor circinelloides f. lusitanicus , Mucor plumbeus)
Mucor plumbeus
Neurospora intermedia
New Stock Fungi Mix (Equal parts Sarocladium strictum , Alternaria alternata , Aspergillus niger , Aureobasidium pullulans , Bipolaris sorokiniana , Botrytis cinerea , Candida albicans , Chaetomium globosum , Cladosporium sphaerospermum , Epicoccum nigrum , Gibberella fujikuroi , Mucor plumbeus , Penicillium chrysogenum var. chrysogenum , Phoma betae , Rhizopus stolonifer , Trichophyton mentagrophytes)
Oat Smut, Ustilago avenae
Paecilomyces variotii
Penicillium chrysogenum var. chrysogenum
Penicillium digitatum
Penicillium Mix (Equal parts Penicillium camemberti , Penicillium chrysogenum , Penicillium digitatum , Penicillium chrysogenum var. chrysogenum , Penicillium roqueforti)
Phoma betae
Phycomycetes Mix (Equal parts Mucor circinelloides f. lusitanicus , Rhizopus stolonifer)
Rhizopus arrhizus
Rhizopus Mix (Equal parts Rhizopus stolonifer , Rhizopus arrhizus)
Rhizopus stolonifer
Rhodotorula mucilaginosa
Saccharomyces cerevisiae
Sarocladium strictum
Stemphylium solani
Trichoderma harzianum
Trichophyton mentagrophytes
Trichophyton rubrum
Trichothecium roseum
Animal Allergens
Canary Feathers, Serinus canaria
Cattle Epithelia, Bos taurus
Chicken Feathers, Gallus gallus
Dog Epithelia, Canis lupus familiaris
Duck Feathers, Anas platyrhynchos
Gerbil Epithelia, Meriones unguiculatus
Goat Epithelia, Capra hircus
Goose Feathers, Anser anser
Guinea Pig Epithelia, Cavia porcellus
Hamster Epithelia, Mesocricetus auratus
Hog Epithelia, Sus scrofa
Horse Epithelia, Equus caballus
Mixed Feathers (Equal parts Gallus gallus , Anas platyrhynchos , Anser anser)
Mouse Epithelia, Mus musculus
Parakeet Feathers, Melopsittacus undulatus
Rabbit Epithelia, Oryctolagus cuniculus
Rat Epithelia, Rattus norvegicus
Silk Worm Cocoon, Bombyx mori
Insects (Whole Body)
Ant, Black Carpenter, Camponotus pennsylvanicus
Ant, Fire, Solenopsis invicta
Ant, Fire, Solenopsis richteri
Cockroach, American, Periplaneta americana
Cockroach, German, Blattella germanica
2 Cockroach Mix (Equal parts Periplaneta americana , Blattella germanica)
Deer Fly, Chrysops vittatus
Flea, Ctenocephalis felis (For Dagnostic Use Only)
House Fly, Musca domestica (For Dagnostic Use Only)
Mosquito, Aedes taeniorhynchus (For Diagnostic Use Only)
Food — Animal Products and Poultry Products
Beef, Bos taurus
Chicken Meat, Gallus gallus
Egg, White, Chicken, Gallus gallus
Egg, Whole, Chicken, Gallus gallus
Egg, Yolk, Chicken, Gallus gallus
Lamb, Ovis aries
Pork, Sus scrofa
Turkey Meat, Meleagris gallopavo
Food — Dairy Products
Milk, Cow, Bos taurus
Food — Fish and Shellfish
Bass, Black, Centropristis striata
Catfish, Channel, Ictalurus punctatus
Clam, Northern Quahog, Mercenaria mercenaria
Cod, Atlantic, Gadus morhua
Crab, Blue, Callinectes sapidus
Fish Mix (Equal parts Gadus morhua , Paralichthys lethostigma , Hippoglossus hippoglossus , Scomber scombrus , Thunnus albacares)
Flounder, Southern, Paralichthys lethostigma
Lobster, American, Homarus americanus
Mackerel, King/Atlantic, Scomber scombrus
Oyster, Atlantic/Eastern, Crassostrea virginica
Perch, Ocean, Sebastes alutus
Salmon, Atlantic, Salmo salar
Scallops, Sea, Placopecten magellanicus
Shellfish Mix (Equal parts Mercenaria mercenaria , Callinectes sapidus , Crassostrea virginica , Placopecten magellanicus , Farfantepenaeus aztecus)
Shrimp, Brown, Farfantepenaeus aztecus
Trout, Rainbow, Oncorhynchus mykiss
Tuna, Yellowfin, Thunnus albacares
Food — Plant Source
Almond, Prunus dulcis
Apple, Malus pumila
Apricot, Prunus armeniaca
Barley, Whole Grain, Hordeum vulgare (For Diagnostic Use Only, Contains SFS*)
Bean, Lima, Phaseolus lunatus
Bean, Navy, Phaseolus vulgaris
Bean, String Green, Phaseolus vulgaris
Blueberry, Velvetleaf, Vaccinium myrtilloides
Brazil Nut, Bertholletia excelsa
Broccoli, Brassica oleracea var. botrytis
Buckwheat, Fagopyrum esculentum
Cabbage, Brassica oleracea var. capitata
Cacao Bean, Theobroma cacao
Cantaloupe, Cucumis melo
Carrot, Daucus carota
Cashew Nut, Anacardium occidentale
Cauliflower, Brassica oleracea var. botrytis
Celery, Apium graveolens var. dulce
Cherry, Sweet, Prunus avium
Cinnamon, Cinnamomum verum
Coconut, Cocos nucifera
Coffee, Coffea arabica (For Diagnostic Use Only)
Corn, Zea mays
Cranberry, Vaccinium macrocarpon
Cucumber, Cucumis sativus
Garlic, Allium sativum
Ginger, Zingiber officinale
Grape, White Seedless, Vitis vinifera
Grapefruit, Citrus X paradisi
Hazelnut (Filbert), Corylus americana
Hops, Humulus lupulus
Lemon, Citrus X limon
Lettuce, Lactuca sativa
Malt (Barley), Hordeum vulgare
Mushroom, Agaricus campestris
Mustard Seed, Sinapis alba
Nutmeg, Myristica fragrans
Oat, Avena sativa (For Diagnostic Use Only, Contains SFS*)
Olive, Green, Olea europaea
Onion, Allium cepa
Orange, Citrus X sinensis
Pea, Green or English, Pisum sativum
Peach, Prunus persica
Peanut, Arachis hypogaea
Pear, Pyrus communis
Pecan, Carya illinoinensis
Pepper, Black, Piper nigrum
Pepper, Green, Capsicum annuum
Pineapple, Ananas comosus (For Diagnostic Use Only, Contains SFS*)
Potato, Sweet, Ipomoea batatas
Potato, White, Solanum tuberosum
Raspberry, Red, Rubus idaeus
Rice, Oryza sativa
Rye, Secale cereale (For Diagnostic Use Only, Contains SFS*)
Sesame Seed, Sesamum indicum
Soybean, Glycine max
Spinach, Spinacia oleracea (For Diagnostic Use Only, Contains SFS*)
Squash, Yellow Summer, Cucurbita pepo var. ovifera
Strawberry, Fragaria X ananassa
Tomato, Solanum lycopersicum
Vanilla, Vanilla planifolia
Walnut, Black, Juglans nigra
Walnut, English, Juglans regia
Watermelon, Citrullus lanatus
Wheat, Whole, Triticum aestivum (For Diagnostic Use Only, Contains SFS*)

*SFS – Sodium Formadehyde Sulfoxylate

16.2 Storage and Handling

Maintain at 2 to 8°C (36 to 46°F) during storage and use.

Dilutions of concentrated extracts that result in a glycerin content of less than 50% can reduce extract stability. Extract dilutions at 1:100 volume to volume should be kept no longer than a month, and more dilute solutions no more than a week. The potency of a dilution can be checked by skin test comparison to a fresh dilution of the extract on a known allergic patient.

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