{"adverse_reactions":["ADVERSE REACTIONS (1) Local Reactions - A mild burning immediately after the injection is to be expected; this usually subsides in 10 to 20 seconds. Reactions at the site of injection (erythema, swelling, pruritus) may be immediate or delayed. Immediate wheal and erythema reactions are ordinarily of little consequence; but if very large, may be the first manifestation of a systemic reaction. Delayed reactions start several hours after injection with local edema, erythema, itching or pain. The reactions are most apparent 24 hours after injection and usually require no treatment. Antihistamines may be administered orally if necessary. Large local reactions may be treated by local applications of cold, wet dressings and/or the use of oral antihistamines. These reactions should be considered a warning of possible severe systemic reaction and need for temporarily reduced dosage. In such cases the next therapeutic dose should be reduced to the last dose which did not elicit a reaction and subsequent doses increased more slowly. ( 2) Systemic Reactions - Most severe systemic reactions occur within 30 minutes of injection but may occur at anytime subsequent to treatment. Symptoms may range from mild to life-threatening (due to anaphylaxis). Systemic reactions are characterized by one or more of the following symptoms: sneezing, mild to severe generalized urticaria, itching other than at the injection site, extensive or generalized edema, wheezing, asthma, dyspnea, cyanosis, tachycardia, lacrimation, marked perspiration, cough, hypotension, syncope and upper airway obstruction. Symptoms may progress to anaphylactic shock and death. If a systemic or anaphylactic reaction does occur, apply a tourniquet above the site of injection and inject 1:1,000 epinephrine-hydrochloride intramuscularly into the opposite arm or gluteal area. Loosen the tourniquet at least every 10 minutes. Do not obstruct arterial blood flow with the tourniquet. 1:1,000 EPHEDRINE DOSAGE: ADULT: 0.3 mL to 0.5 mL should be injected intramuscularly or subcutaneously. Repeat in 5 to 10 minutes if necessary. PEDIATRIC: 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. Doses may be repeated 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 vasoactive drugs if necessary. An open airway should be insured. Give oxygen by mask. Intravenous antihistamine, inhaled bronchodilators, theophyllin and/or adrenal corticosteroids may be used if necessary after adequate epinephrine and circulatory support has been given. Emergency resuscitation measures and personnel trained in their use must be available immediately in the event of a serious systemic or anaphylactic reaction not responsive to the above measures. If the patient is continued on immunotherapy, a decrease of at least 50% in the next dose should follow serious systemic reactions. Increases in dose should be made cautiously. Repeated systemic reactions are sufficient reason for discontinuation of increased dosages. (3) To report suspected ADVERSE REACTIONS, contact Allergy Laboratories, Inc. 800-654-3971 or FDA 800-FDA-1088 or www.fda/gov/medwatch."],"boxed_warning":["WARNINGS This product is intended for use by physicians who are experienced in the administration of allergenic extracts and the emergency care of anaphylaxis, or for use under the guidance of an allergy specialist. Patients should be instructed to recognize adverse reaction symptoms and cautioned to contact physicians’ office if reaction symptoms occur. As with all allergenic extracts, severe systemic reactions may occur. In certain individuals these life threatening reactions may be fatal. Patients should be observed for at least 20 to 30 minutes following treatment and emergency measures as well as personnel trained in their use should be immediately available in the event of a life threatening reaction. Serious adverse reactions can be reported to the US Food and Drug Administration MedWatch, 5600 Fishers Lane, Rockville, Maryland 20852-9787, (800) FDA-1088, or www.fda/gov/medwatch. This product should not be injected intravenously. Patients who are taking non-selective beta blockers may be more reactive to allergens given for testing and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. Refer to the Warnings, Precautions, Adverse Reactions and Dosage sections below."],"carcinogenesis_and_mutagenesis_and_impairment_of_fertility":["(4) CARCINOGENISIS, MUTAGENESIS, IMPAIRMENT OF FERTILITY Long term studies with allergenic extracts have not been conducted in animals to determine their potential for carcinogenesis, mutagenesis, or impairment of fertility."],"clinical_pharmacology":["CLINICAL PHARMACOLOGY Allergenic extracts for diagnostic testing 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 the reaction of antigen with IgE on the surface of basofils, 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. The more mediator released, the larger the reaction. Because of a variety of factors, including the types of allergen extracts, delayed skin reactions can occur and usually disappear within a couple of days. The type of extract, size of the reaction and timing of the reaction are all factors used in determining a patient’s sensitivity to an allergen. Allergen immunotherapy (also known as desensitization, hyposensitization, allergy vaccination, or allergy shots) involves treating a patient with increasing dosage of the allergens to which he is allergic, eventually reaching a dose plateau whereas the patient experiences an increased tolerance upon re-exposure to the allergens. The patient may or may not need to receive continued treatment to demonstrate the desensitization. The exact mechanisms of reaction of desensitization with allergens, which involve the allergen, IgE and IgG antibodies, mast cells and basophils and possibly other mediators, are not completely understood. However, efficacy has been shown in numerous well-controlled studies using specific common allergens. The goals of allergen immunotherapy are to decrease the production of IgE antibodies, initiate the production of IgG antibodies and stabilize mast cells and basophils. Overproduction of IgE in response to an allergen can induce other cells, particularly mast cells and basophils, to initiate a complex chain reaction that results in allergy symptoms. Numerous IgE receptor sites are located on mast cells as well as basophil cells. These cells are among the first cells to be encountered by the antigen. They contain potent chemical mediators (histamine and leukotriene, for example) of inflammation that are released when IgE and a specific allergen cross-link on the cell surface. The release of the chemical mediators results in inflammation and allergy symptoms. As a response to immunotherapy, the production of IgG is believed to work by blocking IgE from binding to mast cells and basophils. Thus IgG, the blocking antibody, may prevent the release of chemical mediators that produce allergy symptoms."],"contraindications":["CONTRAINDICATIONS There are no known absolute contraindications to diagnostic testing or hyposensitization with allergen immunotherapy. Patients with cardiovascular disease or pulmonary disease 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. Immunotherapy is not generally indicated when the offending allergen(s) can be effectively eliminated or minimized by environmental control. There are differences of opinion on the possibility of routine immunizations exacerbating autoimmune diseases. The evidence has been inconclusive. Therefore, caution should be exercised in administering immunotherapy to patients with other immunologic diseases and only administered if the risk from exposure to the allergen is greater than the risk of exacerbating the underlying disorder. Injections should be avoided in patients with a bleeding tendency."],"description":["DESCRIPTION Therapeutic extracts (concentrates) are designed primarily for the physician equipped to prepare dilutions and mixtures as necessary. Allergenic Extracts are manufactured from various biological allergenic source materials including pollens, molds, epidermals, insects, food and environmental inhalants. The extraction is performed in a glycerin solution and the resulting concentration is expressed as weight to volume (w/v) ratio. This is the weight of dry pollen in grams to volume of glycerin extracting solution in milliliters. Extracts are filtered and sterile filled. Tests include those for safety and sterility. The route of administration is subcutaneous. Scratch diagnostic extracts are of the same therapeutic extract formulation and their route of administration is percutaneous. Intradermal diagnostic extracts are dilutions of the therapeutic extracts using Sterile Diluent for Allergenic Extract. Inactive ingredients: Therapeutic and Scratch extracts : Intradermal 1:500 v/v (foods) Intradermal 1:1,000 v/v ( pollens, molds, epidermals, inhalants) Glycerin, USP, 50% v/v Glycerin, USP, 0.1% v/v Glycerin, USP, 0.05% v/v Sodium chloride, USP, 0.166% w/v Sodium chloride, USP, 0.9% w/v Sodium chloride, USP, 0.9% w/v Sodium bicarbonate, USP, 0.091% w/v Sodium bicarbonate, USP, 0.000182% w/v Sodium bicarbonate, USP, 0.000091% w/v Phenol, USP, 0.4% w/v Phenol, USP, 0.4% w/v Sterile Diluent for Allergenic Extract: Normal Saline with Phenol: Human Serum Albumin: Glycerin, USP, 50% w/v Sodium chloride, USP 0.9% w/v Sodium chloride, USP 0.9% w/v Sodium bicarbonate, USP 0.091% w/v Phenol, USP 0.4% w/v Phenol, USP 0.4% w/v Sodium chloride, USP 0.166% w/v Water for Injection, USP q.s. Normal Serum Albumin (Human), 0.03% w/v Water for Injection, USP, q.s. Air replaced with Nitrogen, NF Water for Injection, USP q.s. Air replaced with Nitrogen, NF The following allergenic extracts are designated and labeled “ FOR DIAGNOSTIC USE ONLY ”. Data to support the therapeutic use of these extracts has not been established: Coffee Cottonseed Flaxseed Housefly Mosquito The strength of Standardized Short Ragweed and Ragweed Mix, Giant and Short extracts is described (in addition to w/v) as antigen E content. The concentration of antigen E per milliliter of the final preparation as determined by radial immunodiffusion (RID). The antigen E content of an extract is influenced by several variables. These include antigen E content of the pollen, nature of extracting solutions, ratio of pollen weight to volume of extracting solution and storage conditions. Variables which influence antigen E stability during storage conditions include nature of the solvent, antigen E concentration and storage temperature. Glycerin is a stabilizer of antigen E and other allergens."],"description_table":["
Inactive ingredients:
Therapeutic and Scratch extracts: Intradermal 1:500 v/v (foods) Intradermal 1:1,000 v/v (pollens, molds, epidermals, inhalants)
Glycerin, USP, 50% v/v Glycerin, USP, 0.1% v/v Glycerin, USP, 0.05% v/v
Sodium chloride, USP, 0.166% w/v Sodium chloride, USP, 0.9% w/v Sodium chloride, USP, 0.9% w/v
Sodium bicarbonate, USP, 0.091% w/v Sodium bicarbonate, USP, 0.000182% w/v Sodium bicarbonate, USP, 0.000091% w/v
Phenol, USP, 0.4% w/v Phenol, USP, 0.4% w/v
Sterile Diluent for Allergenic Extract:
Normal Saline with Phenol: Human Serum Albumin: Glycerin, USP, 50% w/v
Sodium chloride, USP 0.9% w/v Sodium chloride, USP 0.9% w/v Sodium bicarbonate, USP 0.091% w/v
Phenol, USP 0.4% w/v Phenol, USP 0.4% w/v Sodium chloride, USP 0.166% w/v
Water for Injection, USP q.s. Normal Serum Albumin (Human), 0.03% w/v Water for Injection, USP, q.s.
Air replaced with Nitrogen, NF Water for Injection, USP q.s.
Air replaced with Nitrogen, NF
"],"dosage_and_administration":["DOSAGE AND ADMINISTRATION Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Allergenic extracts may be administered for diagnostic testing or therapeutic purposes. The dosage will depend on the particular use of the extract. General: When used for diagnostic testing to determine a patient’s sensitivity to specific antigens and aid in the diagnosis and treatment of atopic disease, the recommended procedure is to initially perform puncture tests, then follow with intradermal tests. The number of skin tests applied at one time will depend on the particular patient and their allergic history. These tests should be performed and observed in 15 to 20 minutes. Additional tests may be applied in sequence. Perform tests on the anterolateral aspect of the upper arm on an area that permits the effective application of a tourniquet proximal to the site of the test. The skin at the site of injection should be disinfected with rubbing alcohol before testing. A positive reaction usually develops in 15 to 20 minutes. The positive response is a wheal and flare reaction that is larger than the negative control and evaluated based on the size of the reaction. Controls: A negative control containing the same solution that the extract was prepared in should be applied to a test site in the same manner as the tests being performed. Histamine phosphate should be used as a positive control for evaluation of skin testing. Refer to manufacturers directions provided with Histamine phosphate for recommended dosage and administration. Percutaneous testing : In general, skin is scratched, punctured or pricked just before the allergen is applied or through a drop of test allergen which is placed on the skin. There are several devices available for this technique. Refer to the device manufacturers instructions for proper use. Test areas should be no closer than 4-5 cm apart to avoid the interference of multiple reactions. Clean test areas with alcohol and air dry. Place the allergen on the volar surface of the patient’s forearm, upper arm, or back. 1. For puncture tests, apply one drop of extract to the skin. Pierce the drop of extract and skin using a sterile hypodermic needle or vaccinating needle. Maintain the needle perpendicular to the skin surface and rock the needle back and forth to produce a small hole without bleeding. Do not rotate or gouge the needle. Remove needle from skin and wipe excess extract from skin surface. 2. For scratch tests using a scarifier or needle: make a scratch 1/16 inch long on the epidermis penetrating the outer cornified area but being careful not to draw blood. Apply one drop of allergen to the scratch or puncture. Intracutaneous ( Intradermal ) testing: If puncture test is negative, proceed with intradermal test. Intradermal tests should not be performed if puncture test is positive. Use a separate sterile syringe (tuberculin type equipped with a 27 gauge by 3/8 inch needle with intradermal bevel) for each antigen. To administer the test, inject 0.02 mL of allergen into the epidermis using dilutions of the concentrated extract; a 1:500 v/v dilution for foods and 1:1,000 v/v dilution for other extracts. If the test has been performed properly, the solution should raise a bleb 2 to 3 mm in diameter. If the bleb does not appear, the injection was made too deeply. To prepare intradermal testing strengths using 1:20 w/v bulk concentrates, use the following example: Add 1 mL of 1:20 w/v to 4 mL diluent to make a 1:100 v/v dilution. Add 1 mL of 1:100 v/v to 4 mL diluent to make a 1:500 v/v dilution. Add 0.5 mL of 1:100 v/v dilution to 4.5 mL diluent to make a 1:1,000 v/v dilution. Interpretation of results: Percutaneous tests Intradermal tests 1 1+ Erythema with 5mm wheal 0 <5mm Erythema with a <5mm wheal 2+ Erythema with a 5-10mm wheal +/- 5-10mm Erythema with a 5-10mm wheal 3+ Erythema with a 10-15mm wheal 1+ 11-20mm Erythema with a 5-10mm wheal 4+ Erythema with a wheal 15mm or larger with pseudopodia 2+ 21-30mm Erythema with a 5-10mm wheal 3+ 31-40mm Erythema with a 10-15mm wheal or with pseudopodia 4+ >40mm Erythema with >15mm wheal or with pseudopodia Immunotherapy: (1) General : Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Injections are given subcutaneously; preferably in the arm. It is advantageous to give injections in alternate arms. Use sterile precautions and a tuberculin syringe when administering each dose. Allergen immunotherapy is typically initiated with a diluted formulation of allergens prescribed by a physician for administration to a patient. Doses are gradually increased over time and ultimately reach a maintenance dose where the patient is maintained for as long as the physician or patient feels is necessary. The formulation and dosage schedule is determined by the physician and is based on diagnostic testing and patient history. Patients with very high sensitivities should be initiated with lower concentrations (higher dilutions) and may need a very relaxed progression to maintenance doses. Pre-seasonal therapy may be initiated three months before seasonal difficulty begins and brought to maintenance dose and discontinued after that season ends. Perennial therapy (recommended) brings the patient up to tolerated maintenance dose where they remain until improvement of allergic symptoms occurs. Injections may be given at intervals of 4 to 7 days with either therapy. (2) Suggested dilution series : Concentrated Allergenic Extracts must be diluted with Sterile Diluent for Allergenic Extract before using for immunotherapy. A 1:100,000 v/v dilution of concentrate is usually satisfactory to start treatment. To prepare a 10-fold dilution series from concentrated bulk extract, the following is suggested: Add 1 mL of 1:20 w/v extract to 4 mL diluent to make a 1:100 v/v dilution. Add 0.5 mL of the 1:100 dilution to 4.5 mL of diluent to make a 1:1,000 v/v dilution. Add 0.5 mL of the 1:1,1000 dilution to 4.5 mL diluent to make a 1:10,000 v/v dilution. Add 0.5 mL of the 1:10,000 dilution to 4.5 mL of diluent to make a 1:100,000 v/v dilution. The series may be extended to 1:1,000,000 v/v by preparing one more similar dilution as a precaution for sensitive patients. (3) Maintenance: The maintenance level is the largest dose tolerated by the patient that relieves symptoms without producing undesirable local or general reactions. After immunotherapy has been established, a maintenance dose should be given at weekly intervals. The interval between maintenance doses can be increased gradually from one week to 10 days, to 2 weeks, 3 weeks, or even 4 weeks as allergy symptoms allow. Repeat maintenance doses at a given interval three or four times to check for continued allergy symptom relief before increasing the interval further. If large local (or systemic) reactions occur at one interval, do not increase the interval. Protection is lost rapidly if the interval between doses is more than 4 weeks. It may not be possible for all patients to reach the maximum dose indicated on the suggested dosage schedule. (4) Suggested dosage schedule: Because the degree of sensitivity varies in many individuals, the dose and interval may need adjustment and should reflect the patient’s tolerance and response. A dose should never be given until all reactions resulting from a previous dose have entirely disappeared. After a period on immunotherapy, better tolerance may permit a longer interval between injections, or a larger maintenance dose, or both. 1:100,000 v/v 1:10,000 v/v 1:1,000 v/v 1:100 v/v Dose Vol. (mL) Dose Vol. (mL) Dose Vol. (mL) Dose Vol. (mL) Maintenance 1 0.02 8 0.02 13 0.02 19 0.02 2 0.04 9 0.05 14 0.05 20 0.05 Continue 0.25 mL of 1:100 v/v weekly. 3 0.06 10 0.10 15 0.10 21 0.08 4 0.10 11 0.15 16 0.15 22 0.10 5 0.15 12 0.25 17 0.20 23 0.15 6 0.20 18 0.25 24 0.20 7 0.25 25 0.25 (5) Dose adjustments: Since the individual components of the extract are those to which the patient is allergic and to which he will be exposed, typical allergic symptoms may follow shortly after the injection, particularly those experienced by the patient during exposure when the antigen from the environment plus the injected antigen exceeds the patient’s tolerance to the antigen. In such cases, decrease the size of the next scheduled dose by at least one-half of the previous dose. (6) Administration : Use aseptic precautions when diluting and/or preparing an injection. To avoid cross-contamination, do not use the same needle to withdraw materials from multiple vials. Use a sterile tuberculin syringe (26 or 27 gauge) with a needle at least 5/8” long and graduated in 0.01 mL units to measure each dose."],"dosage_and_administration_table":["
Interpretation of results:
Percutaneous tests Intradermal tests 1
1+ Erythema with 5mm wheal 0 <5mm Erythema with a <5mm wheal
2+ Erythema with a 5-10mm wheal +/- 5-10mm Erythema with a 5-10mm wheal
3+ Erythema with a 10-15mm wheal 1+ 11-20mm Erythema with a 5-10mm wheal
4+ Erythema with a wheal 15mm or larger with pseudopodia 2+ 21-30mm Erythema with a 5-10mm wheal
3+ 31-40mm Erythema with a 10-15mm wheal or with pseudopodia
4+ >40mm Erythema with >15mm wheal or with pseudopodia
","
1:100,000 v/v 1:10,000 v/v 1:1,000 v/v 1:100 v/v
Dose Vol. (mL) Dose Vol. (mL) Dose Vol. (mL) Dose Vol. (mL) Maintenance
1 0.02 8 0.02 13 0.02 19 0.02
2 0.04 9 0.05 14 0.05 20 0.05 Continue 0.25 mL of 1:100 v/v weekly.
3 0.06 10 0.10 15 0.10 21 0.08
4 0.10 11 0.15 16 0.15 22 0.10
5 0.15 12 0.25 17 0.20 23 0.15
6 0.20 18 0.25 24 0.20
7 0.25 25 0.25
"],"drug_interactions":["(3) DRUG INTERACTIONS Beta-Blockers: Patients who are taking non-selective beta blockers may be more reactive to allergens given for testing and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. Patients with cardiovascular diseases and/or pulmonary diseases such as symptomatic unstable, steroid-dependent asthma, and/or those who are receiving cardiovascular drugs such as beta-blockers, may be at higher risk for severe adverse reactions. Antihistamines can significantly inhibit the immediate skin test reactions. If long acting antihistamines have been taken recently, it is recommended that they should be stopped for the following minimum intervals before skin testing is performed: 1 week for hydroxyzine or cetirizine; 4 to 7 days for loratadine; 3 to 4 days for fexofenadine; and 24 to 48 hours for other sustained release antihistamines."],"effective_time":"20110311","general_precautions":["(1) GENERAL The presence of asthmatic signs and symptoms may be an indicator of severe reaction following allergen injections. Any evidence of a local or generalized reaction requires a dose reduction during the initial stages of immunotherapy, as well as during maintenance therapy. Patient reactions to previous injections should be reviewed before each new injection and a conservative dosage schedule should be followed until a pattern of local responses is established which can be used to monitor increases in dosage. Patients should be observed in the office for at least 20 to 30 minutes after each treatment injection and instructed to seek medical attention if symptoms of a systemic reaction occur. Most severe reactions will occur within this time period, and rapid treatment measures should be initiated (see ADVERSE REACTIONS). In rare circumstances, a patient may have systemic reactions to minute doses of antigen and does not demonstrate increasing tolerance to injections after several months of treatment. If systemic reactions or excessive local responses occur persistently at very small doses, efforts at immunotherapy should be stopped. When changing lots of extracts, even though the formulation may be the same, the first dose should not exceed 50% of the previous dose as the extract may have lost potency over time and a fresh extract could have an effective potency that is substantially greater than that of the old extract. Aseptic technique should always be used when injections of allergenic extracts are administered."],"how_supplied":["HOW SUPPLIED Bulk extract (stock concentrate) in 50% v/v glycerin is supplied in 10 mL, 30 mL, and 50 mL multiple dose vials as well as 2 mL scratch (dropper) vials. Intradermal tests are supplied in 5 mL vials at 1:500 v/v for food extracts and at 1:1,000 v/v for other extracts."],"id":"dbe7bebd-e445-4e59-8302-e706b795fbde","indications_and_usage":["INDICATIONS AND USAGE Immunotherapy using allergenic extracts is indicated for use in patients with severe allergy symptoms (hay fever, rhinitis, etc.) to pollens, molds, insects, animal danders and various other allergens. Immunotherapy is intended for patients whose symptoms are not satisfactorily controlled by avoidance of the offending allergen or by the use of symptomatic medications. Treatment uses only those specific allergens that the patient is sensitive to based on diagnostic tests and medical history. It is not intended for treatment of patients who do not manifest immediate hypersensitivity reactions to the allergenic extract following skin testing."],"information_for_patients":["(2) INFORMATION FOR PATIENTS Patients should be instructed to remain in the office for 20 to 30 minutes after each injection to monitor for adverse reactions. Patients should be instructed to describe any active allergic symptoms such as rhinitis, wheezing, dyspnea, etc. prior to injection including any late reactions from previous administration."],"nursing_mothers":["(6) NURSING MOTHERS It is not known if allergenic extracts appear in human milk. Because many drugs are excreted in human milk, caution should be exercised when allergenic extracts are administered to a nursing woman."],"openfda":{},"overdosage":["OVERDOSAGE Signs and symptoms of overdose are typically local and systemic reactions. For a description and management of overdose reactions, see ADVERSE REACTIONS."],"package_label_principal_display_panel":["PRINCIPAL DISPLAY PANEL ALLERGENIC EXTRACT RX ONLY PRINCIPAL DISPLAY PANEL ALLERGENIC EXTRACT RX ONLY","PRINCIPAL DISPLAY PANEL ALLERGENIC EXTRACT SCRATCH TESTING RX ONLY PRINCIPAL DISPLAY PANEL ALLERGENIC EXTRACT SCRATCH TESTING RX ONLY"],"pediatric_use":["(7) PEDIATRIC USE Extracts have not been studied in children, so the safety in children has not been established. Doses of allergenic extracts for children are generally the same as those for adults. In the case of large doses, the amount of extract given to a child may be modified so that the discomfort of the injection is minimized."],"precautions":["PRECAUTIONS (1) GENERAL The presence of asthmatic signs and symptoms may be an indicator of severe reaction following allergen injections. Any evidence of a local or generalized reaction requires a dose reduction during the initial stages of immunotherapy, as well as during maintenance therapy. Patient reactions to previous injections should be reviewed before each new injection and a conservative dosage schedule should be followed until a pattern of local responses is established which can be used to monitor increases in dosage. Patients should be observed in the office for at least 20 to 30 minutes after each treatment injection and instructed to seek medical attention if symptoms of a systemic reaction occur. Most severe reactions will occur within this time period, and rapid treatment measures should be initiated (see ADVERSE REACTIONS). In rare circumstances, a patient may have systemic reactions to minute doses of antigen and does not demonstrate increasing tolerance to injections after several months of treatment. If systemic reactions or excessive local responses occur persistently at very small doses, efforts at immunotherapy should be stopped. When changing lots of extracts, even though the formulation may be the same, the first dose should not exceed 50% of the previous dose as the extract may have lost potency over time and a fresh extract could have an effective potency that is substantially greater than that of the old extract. Aseptic technique should always be used when injections of allergenic extracts are administered. (2) INFORMATION FOR PATIENTS Patients should be instructed to remain in the office for 20 to 30 minutes after each injection to monitor for adverse reactions. Patients should be instructed to describe any active allergic symptoms such as rhinitis, wheezing, dyspnea, etc. prior to injection including any late reactions from previous administration. (3) DRUG INTERACTIONS Beta-Blockers: Patients who are taking non-selective beta blockers may be more reactive to allergens given for testing and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. Patients with cardiovascular diseases and/or pulmonary diseases such as symptomatic unstable, steroid-dependent asthma, and/or those who are receiving cardiovascular drugs such as beta-blockers, may be at higher risk for severe adverse reactions. Antihistamines can significantly inhibit the immediate skin test reactions. If long acting antihistamines have been taken recently, it is recommended that they should be stopped for the following minimum intervals before skin testing is performed: 1 week for hydroxyzine or cetirizine; 4 to 7 days for loratadine; 3 to 4 days for fexofenadine; and 24 to 48 hours for other sustained release antihistamines. (4) CARCINOGENISIS, MUTAGENESIS, IMPAIRMENT OF FERTILITY Long term studies with allergenic extracts have not been conducted in animals to determine their potential for carcinogenesis, mutagenesis, or impairment of fertility. (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 if they can affect reproduction capacity. The physician must weigh the benefits of immunotherapy against the risk of anaphylactic reactions that could result in harm to the mother and/or fetus. Hyposensitization should be used during pregnancy only if clearly necessary and administered cautiously. (6) NURSING MOTHERS It is not known if allergenic extracts appear in human milk. Because many drugs are excreted in human milk, caution should be exercised when allergenic extracts are administered to a nursing woman. (7) PEDIATRIC USE Extracts have not been studied in children, so the safety in children has not been established. Doses of allergenic extracts for children are generally the same as those for adults. In the case of large doses, the amount of extract given to a child may be modified so that the discomfort of the injection is minimized."],"pregnancy":["(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 if they can affect reproduction capacity. The physician must weigh the benefits of immunotherapy against the risk of anaphylactic reactions that could result in harm to the mother and/or fetus. Hyposensitization should be used during pregnancy only if clearly necessary and administered cautiously."],"references":["REFERENCES Norman, P.S.: In vivo methods of study of allergy: Skin and Mucosal tests, techniques, and interpretation. In Middleton, E. Jr., Reed, C. E. and Ellis, E.F. (ed): Allergy Principles and Practice, (Vol. 1), p. 258. St. Louis, The C.V. Mosby Co. 1978. ALLERGY LABORATORIES, INC. U.S. License # 103 Oklahoma City, OK 73109 (800) 654-3971, (405) 235-1451 Rev. 12/2010"],"set_id":"c1114779-3e11-47ab-8889-f534406f4041","spl_product_data_elements":["APPLE apple APPLE APPLE SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN APRICOT apricot APRICOT APRICOT SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN AVOCADO avocado AVOCADO AVOCADO SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BANANA banana BANANA BANANA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BLACKBERRY blackberry BLACKBERRY BLACKBERRY SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLUEBERRY blue ridge blueberry BLUE RIDGE BLUEBERRY BLUE RIDGE BLUEBERRY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CANTALOUPE cantaloupe CANTALOUPE CANTALOUPE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CHERRY FOOD cherry CHERRY CHERRY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CRANBERRY cranberry CRANBERRY CRANBERRY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER DATE date DATE DATE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BASIL basil BASIL BASIL SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GRAPEFRUIT grapefruit GRAPEFRUIT GRAPEFRUIT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BLACK BASS largemouth bass LARGEMOUTH BASS LARGEMOUTH BASS SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER LEMON lemon LEMON LEMON SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER LIME lime, citrus LIME (CITRUS) LIME (CITRUS) SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER ORANGE FOOD orange ORANGE ORANGE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PEACH peach PEACH PEACH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PEAR pear PEAR PEAR SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PINEAPPLE pineapple PINEAPPLE PINEAPPLE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PINTO BEAN kidney bean KIDNEY BEAN KIDNEY BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BEEF beef BEEF BEEF SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER STRAWBERRY strawberry STRAWBERRY STRAWBERRY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CATFISH catfish CATFISH CATFISH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER WATERMELON watermelon WATERMELON WATERMELON SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CHICKEN FOOD chicken CHICKEN CHICKEN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CLAM quahog QUAHOG QUAHOG SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER RED KIDNEY BEAN kidney bean KIDNEY BEAN KIDNEY BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER LIMA BEAN lima bean LIMA BEAN LIMA BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER NAVY BEAN kidney bean KIDNEY BEAN KIDNEY BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GREEN STRING BEAN string bean STRING BEAN STRING BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CODFISH cod COD COD SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BROCCOLI broccoli BROCCOLI BROCCOLI SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CRAB MEAT blue crab BLUE CRAB BLUE CRAB SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BRUSSEL SPROUTS brussels sprout BRUSSELS SPROUT BRUSSELS SPROUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CABBAGE cabbage CABBAGE CABBAGE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CARROT carrot CARROT CARROT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CAULIFLOWER cauliflower CAULIFLOWER CAULIFLOWER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CELERY celery CELERY CELERY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER EGG WHITE egg white EGG WHITE EGG WHITE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CUCUMBER cucumber CUCUMBER CUCUMBER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER WHOLE EGG egg EGG EGG SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GREEN PEPPER green bell pepper GREEN BELL PEPPER GREEN BELL PEPPER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER EGG YOLK egg yolk EGG YOLK EGG YOLK SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER LETTUCE lettuce LETTUCE LETTUCE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER MUSHROOM FOOD cultivated mushroom CULTIVATED MUSHROOM CULTIVATED MUSHROOM SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER FLOUNDER flounder FLOUNDER FLOUNDER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GREEN OLIVE green olive GREEN OLIVE GREEN OLIVE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER ONION onion ONION ONION SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PARSLEY parsley PARSLEY PARSLEY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GREEN PEA pea PEA PEA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SWEET POTATO sweet potato SWEET POTATO SWEET POTATO SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER WHITE POTATO potato POTATO POTATO SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GRAPE concord grape CONCORD GRAPE CONCORD GRAPE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER RADISH radish RADISH RADISH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER RHUBARB rhubarb RHUBARB RHUBARB SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SOYBEAN soybean SOYBEAN SOYBEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SPINACH spinach SPINACH SPINACH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER YELLOW SQUASH squash SQUASH SQUASH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER TOMATO tomato TOMATO TOMATO SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER HADDOCK haddock HADDOCK HADDOCK SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER HALIBUT pacific halibut PACIFIC HALIBUT PACIFIC HALIBUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER COW MILK cow milk COW MILK COW MILK SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CASHEW NUT cashew CASHEW CASHEW SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER COCONUT coconut COCONUT COCONUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER ENGLISH WALNUT FOOD english walnut ENGLISH WALNUT ENGLISH WALNUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BLACK PEPPER black pepper BLACK PEPPER BLACK PEPPER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PEANUT FOOD peanut PEANUT PEANUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PECAN FOOD pecan PECAN PECAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PERCH perch PERCH PERCH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BARLEY FOOD barley BARLEY BARLEY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BUCKWHEAT buckwheat BUCKWHEAT BUCKWHEAT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER OATS FOOD oat OAT OAT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER RICE FOOD rice RICE RICE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER RYE FOOD rye RYE RYE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER WHOLE WHEAT FOOD wheat WHEAT WHEAT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PIMENTO red bell pepper RED BELL PEPPER RED BELL PEPPER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PORK pork PORK PORK SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PACIFIC SALMON pink salmon PINK SALMON PINK SALMON SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PAPAYA papaya PAPAYA PAPAYA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SCALLOP scallop SCALLOP SCALLOP SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SHRIMP shrimp SHRIMP SHRIMP SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SUNFLOWER SEED sunflower seed SUNFLOWER SEED SUNFLOWER SEED SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BLACKEYED PEA black-eyed pea BLACK-EYED PEA BLACK-EYED PEA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CORN FOOD corn CORN CORN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CACAO BEAN cocoa COCOA COCOA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER COFFEE FOR DIAGNOSTIC USE ONLY coffee bean COFFEE BEAN COFFEE BEAN SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BARLEY MALT barley malt BARLEY MALT BARLEY MALT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER CINNAMON cinnamon CINNAMON CINNAMON SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER DILL SEED dill DILL DILL SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GARLIC garlic GARLIC GARLIC SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER GINGER ginger GINGER GINGER SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER HORSERADISH horseradish HORSERADISH HORSERADISH SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER MUSTARD SEED mustard seed MUSTARD SEED MUSTARD SEED SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER OREGANO oregano OREGANO OREGANO SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER PEPPERMINT peppermint PEPPERMINT PEPPERMINT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER POPPY SEED poppy seed POPPY SEED POPPY SEED SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SAGE FOOD sage SAGE SAGE SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SESAME SEED sesame seed SESAME SEED SESAME SEED SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER SPEARMINT spearmint SPEARMINT SPEARMINT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER THYME thyme THYME THYME SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER VANILLA vanilla VANILLA VANILLA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER ALMOND almond ALMOND ALMOND SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ACACIA POLLEN acacia ACACIA ACACIA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RED ALDER POLLEN alnus rubra pollen ALNUS RUBRA POLLEN ALNUS RUBRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SMOOTH ALDER POLLEN alnus incana subsp. rugosa pollen ALNUS INCANA SUBSP. RUGOSA POLLEN ALNUS INCANA SUBSP. RUGOSA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ARIZONA ASH POLLEN fraxinus velutina pollen FRAXINUS VELUTINA POLLEN FRAXINUS VELUTINA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GREEN RED ASH POLLEN fraxinus pennsylvanica pollen FRAXINUS PENNSYLVANICA POLLEN FRAXINUS PENNSYLVANICA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE ASH POLLEN fraxinus americana pollen FRAXINUS AMERICANA POLLEN FRAXINUS AMERICANA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ASH MIX, GREEN/WHITE POLLEN fraxinus americana pollen and fraxinus pennsylvanica pollen FRAXINUS AMERICANA POLLEN FRAXINUS AMERICANA POLLEN FRAXINUS PENNSYLVANICA POLLEN FRAXINUS PENNSYLVANICA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN QUAKING ASPEN POLLEN populus tremuloides pollen POPULUS TREMULOIDES POLLEN POPULUS TREMULOIDES POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BAYBERRY POLLEN morella cerifera pollen MORELLA CERIFERA POLLEN MORELLA CERIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN AMERICAN BEECH POLLEN fagus grandifolia pollen FAGUS GRANDIFOLIA POLLEN FAGUS GRANDIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BOX ELDER POLLEN acer negundo pollen ACER NEGUNDO POLLEN ACER NEGUNDO POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MOUNTAIN CEDAR POLLEN juniperus ashei pollen JUNIPERUS ASHEI POLLEN JUNIPERUS ASHEI POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PINCHOT CEDAR POLLEN juniperus pinchotii pollen JUNIPERUS PINCHOTII POLLEN JUNIPERUS PINCHOTII POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RED CEDAR POLLEN juniperus virginiana pollen JUNIPERUS VIRGINIANA POLLEN JUNIPERUS VIRGINIANA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN EASTERN COTTONWOOD POLLEN populus deltoides pollen POPULUS DELTOIDES POLLEN POPULUS DELTOIDES POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WESTERN COTTONWOOD POLLEN populus deltoides subsp. monilifera pollen POPULUS DELTOIDES SUBSP. MONILIFERA POLLEN POPULUS DELTOIDES SUBSP. MONILIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COTTONWOOD MIX, EASTERN/WESTERN POLLEN populus deltoides subsp. monilifera pollen and populus deltoides pollen POPULUS DELTOIDES SUBSP. MONILIFERA POLLEN POPULUS DELTOIDES SUBSP. MONILIFERA POLLEN POPULUS DELTOIDES POLLEN POPULUS DELTOIDES POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ARIZONA CYPRESS POLLEN cupressus arizonica pollen CUPRESSUS ARIZONICA POLLEN CUPRESSUS ARIZONICA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BALD CYPRESS POLLEN taxodium distichum pollen TAXODIUM DISTICHUM POLLEN TAXODIUM DISTICHUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN AMERICAN ELM POLLEN ulmus americana pollen ULMUS AMERICANA POLLEN ULMUS AMERICANA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CEDAR FALL BLOOMING ELM POLLEN ulmus crassifolia pollen ULMUS CRASSIFOLIA POLLEN ULMUS CRASSIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CHINESE SIBERIAN ELM POLLEN ulmus pumila pollen ULMUS PUMILA POLLEN ULMUS PUMILA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ELM MIX, AMERICAN/CHINESE/SLIPPERY POLLEN ulmus pumila pollen and ulmus americana pollen and ulmus rubra pollen ULMUS PUMILA POLLEN ULMUS PUMILA POLLEN ULMUS AMERICANA POLLEN ULMUS AMERICANA POLLEN ULMUS RUBRA POLLEN ULMUS RUBRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN EUCALYPTUS BLUE GUM POLLEN eucalyptus globulus pollen EUCALYPTUS GLOBULUS POLLEN EUCALYPTUS GLOBULUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DOUGLAS FIR POLLEN pseudotsuga menziesii pollen PSEUDOTSUGA MENZIESII POLLEN PSEUDOTSUGA MENZIESII POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SWEETGUM POLLEN liquidambar styraciflua pollen LIQUIDAMBAR STYRACIFLUA POLLEN LIQUIDAMBAR STYRACIFLUA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HACKBERRY POLLEN celtis occidentalis pollen CELTIS OCCIDENTALIS POLLEN CELTIS OCCIDENTALIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SHAGBARK HICKORY POLLEN carya ovata pollen CARYA OVATA POLLEN CARYA OVATA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE HICKORY POLLEN carya tomentosa pollen CARYA TOMENTOSA POLLEN CARYA TOMENTOSA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HICKORY MIX, PIGNUT/SHAGBARK/SHELLBARK/WHITE POLLEN carya tomentosa pollen and carya laciniosa pollen and carya ovata pollen and carya glabra pollen CARYA TOMENTOSA POLLEN CARYA TOMENTOSA POLLEN CARYA LACINIOSA POLLEN CARYA LACINIOSA POLLEN CARYA OVATA POLLEN CARYA OVATA POLLEN CARYA GLABRA POLLEN CARYA GLABRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ONE SEED JUNIPER POLLEN juniperus monosperma pollen JUNIPERUS MONOSPERMA POLLEN JUNIPERUS MONOSPERMA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ROCKY MOUNTAIN JUNIPER POLLEN juniperus scopulorum pollen JUNIPERUS SCOPULORUM POLLEN JUNIPERUS SCOPULORUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RIVER BIRCH POLLEN betula nigra pollen BETULA NIGRA POLLEN BETULA NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BIRCH MIX, RIVER/PAPER/SWEET/WHITE POLLEN betula nigra pollen and betula papyrifera pollen and betula lenta pollen and betula populifolia pollen BETULA NIGRA POLLEN BETULA NIGRA POLLEN BETULA PAPYRIFERA POLLEN BETULA PAPYRIFERA POLLEN BETULA LENTA POLLEN BETULA LENTA POLLEN BETULA POPULIFOLIA POLLEN BETULA POPULIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE GRAY BIRCH POLLEN betula populifolia pollen BETULA POPULIFOLIA POLLEN BETULA POPULIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SUGAR HARD MAPLE POLLEN acer saccharum pollen ACER SACCHARUM POLLEN ACER SACCHARUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MAPLE MIX, RED/SILVER/SUGAR POLLEN acer saccharum pollen and acer saccharinum pollen and acer rubrum pollen ACER SACCHARUM POLLEN ACER SACCHARUM POLLEN ACER SACCHARINUM POLLEN ACER SACCHARINUM POLLEN ACER RUBRUM POLLEN ACER RUBRUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MESQUITE POLLEN prosopis juliflora pollen PROSOPIS JULIFLORA POLLEN PROSOPIS JULIFLORA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PAPER MULBERRY POLLEN broussonetia papyrifera pollen BROUSSONETIA PAPYRIFERA POLLEN BROUSSONETIA PAPYRIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RED MULBERRY POLLEN morus rubra pollen MORUS RUBRA POLLEN MORUS RUBRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE MULBERRY POLLEN morus alba pollen MORUS ALBA POLLEN MORUS ALBA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLACK OAK POLLEN quercus velutina pollen QUERCUS VELUTINA POLLEN QUERCUS VELUTINA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLACKJACK OAK POLLEN quercus nigra pollen QUERCUS NIGRA POLLEN QUERCUS NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BUR OAK POLLEN quercus macrocarpa pollen QUERCUS MACROCARPA POLLEN QUERCUS MACROCARPA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN LIVE OAK POLLEN quercus virginiana pollen QUERCUS VIRGINIANA POLLEN QUERCUS VIRGINIANA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN 2-OAK MIX, RED/WHITE POLLEN quercus rubra pollen and quercus alba pollen QUERCUS RUBRA POLLEN QUERCUS RUBRA POLLEN QUERCUS ALBA POLLEN QUERCUS ALBA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN 5-OAK MIX, BLACKJACK/BUR/POST/RED/WHITE POLLEN quercus nigra pollen and quercus macrocarpa pollen and quercus stellata pollen and quercus rubra pollen and quercus alba pollen QUERCUS NIGRA POLLEN QUERCUS NIGRA POLLEN QUERCUS MACROCARPA POLLEN QUERCUS MACROCARPA POLLEN QUERCUS STELLATA POLLEN QUERCUS STELLATA POLLEN QUERCUS RUBRA POLLEN QUERCUS RUBRA POLLEN QUERCUS ALBA POLLEN QUERCUS ALBA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN 3-OAK MIX, BLACK/BLACKJACK/POST POLLEN quercus velutina pollen and quercus nigra pollen and quercus stellata pollen QUERCUS VELUTINA POLLEN QUERCUS VELUTINA POLLEN QUERCUS NIGRA POLLEN QUERCUS NIGRA POLLEN QUERCUS STELLATA POLLEN QUERCUS STELLATA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN POST OAK POLLEN quercus stellata pollen QUERCUS STELLATA POLLEN QUERCUS STELLATA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN QUEEN PALM POLLEN syagrus romanzoffiana pollen SYAGRUS ROMANZOFFIANA POLLEN SYAGRUS ROMANZOFFIANA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN EUROPEAN OLIVE POLLEN olea europaea pollen OLEA EUROPAEA POLLEN OLEA EUROPAEA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DATE PALM POLLEN phoenix dactylifera pollen PHOENIX DACTYLIFERA POLLEN PHOENIX DACTYLIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PECAN POLLEN carya illinoinensis pollen CARYA ILLINOINENSIS POLLEN CARYA ILLINOINENSIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE PINE POLLEN pinus strobus pollen PINUS STROBUS POLLEN PINUS STROBUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN 4-PINE MIX, AUSTRIAN/LOBLOLLY/SCOTCH/WHITE POLLEN pinus strobus pollen and pinus sylvestris pollen and pinus taeda pollen and pinus nigra pollen PINUS STROBUS POLLEN PINUS STROBUS POLLEN PINUS SYLVESTRIS POLLEN PINUS SYLVESTRIS POLLEN PINUS TAEDA POLLEN PINUS TAEDA POLLEN PINUS NIGRA POLLEN PINUS NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN LOMBARDY POPLAR POLLEN populus nigra pollen POPULUS NIGRA POLLEN POPULUS NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE POPLAR POLLEN populus alba pollen POPULUS ALBA POLLEN POPULUS NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PRIVET POLLEN ligustrum vulgare pollen LIGUSTRUM VULGARE POLLEN LIGUSTRUM VULGARE POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLUE SPRUCE POLLEN picea pungens pollen PICEA PUNGENS POLLEN PICEA PUNGENS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN UPLAND SUMAC POLLEN rhus glabra pollen RHUS GLABRA POLLEN RHUS GLABRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SYCAMORE POLLEN platanus occidentalis pollen PLATANUS OCCIDENTALIS POLLEN PLATANUS OCCIDENTALIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TREE OF HEAVEN POLLEN ailanthus altissima pollen AILANTHUS ALTISSIMA POLLEN AILANTHUS ALTISSIMA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLACK WALNUT POLLEN juglans nigra pollen JUGLANS NIGRA POLLEN JUGLANS NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLACK WILLOW POLLEN salix nigra pollen SALIX NIGRA POLLEN SALIX NIGRA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PUSSY WILLOW POLLEN salix discolor pollen SALIX DISCOLOR POLLEN SALIX DISCOLOR POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLACK LOCUST POLLEN robinia pseudoacacia pollen ROBINIA PSEUDOACACIA POLLEN ROBINIA PSEUDOACACIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHITE OAK POLLEN quercus alba pollen QUERCUS ALBA POLLEN QUERCUS ALBA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BAHIA GRASS POLLEN paspalum notatum pollen PASPALUM NOTATUM POLLEN PASPALUM NOTATUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CULTIVATED BARLEY POLLEN hordeum vulgare pollen HORDEUM VULGARE POLLEN HORDEUM VULGARE POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CREEPING BENT GRASS POLLEN agrostis stolonifera pollen AGROSTIS STOLONIFERA POLLEN AGROSTIS STOLONIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ANNUAL BLUEGRASS POLLEN poa annua pollen POA ANNUA POLLEN POA ANNUA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HUNGARIAN SMOOTH BROME POLLEN bromus inermis pollen BROMUS INERMIS POLLEN BROMUS INERMIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CANARY GRASS POLLEN phalaris minor pollen PHALARIS MINOR POLLEN PHALARIS MINOR POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SOUTHERN CHEAT CHESS POLLEN bromus secalinus pollen BROMUS SECALINUS POLLEN BROMUS SECALINUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CULTIVATED CORN POLLEN zea mays pollen ZEA MAYS POLLEN ZEA MAYS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BLUE GRAMA GRASS bouteloua gracilis pollen BOUTELOUA GRACILIS POLLEN BOUTELOUA GRACILIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN JOHNSON GRASS POLLEN sorghum halepense pollen SORGHUM HALEPENSE POLLEN SORGHUM HALEPENSE POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TALL OAT GRASS POLLEN arrhenatherum elatius pollen ARRHENATHERUM ELATIUS POLLEN ARRHENATHERUM ELATIUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CULTIVATED OATS POLLEN avena sativa pollen AVENA SATIVA POLLEN AVENA SATIVA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN QUACK GRASS POLLEN elymus repens pollen ELYMUS REPENS POLLEN ELYMUS REPENS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ITALIAN RYEGRASS POLLEN lolium perenne subsp. multiflorum pollen LOLIUM PERENNE SUBSP. MULTIFLORUM POLLEN LOLIUM PERENNE SUBSP. MULTIFLORUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GRAIN SORGHUM POLLEN sorghum bicolor subsp. bicolor pollen SORGHUM BICOLOR SUBSP. BICOLOR POLLEN SORGHUM BICOLOR SUBSP. BICOLOR POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SUDAN GRASS POLLEN sorghum bicolor subsp. drummondii pollen SORGHUM BICOLOR SUBSP. DRUMMONDII POLLEN SORGHUM BICOLOR SUBSP. DRUMMONDII POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CULTIVATED WHEAT POLLEN triticum aestivum pollen TRITICUM AESTIVUM POLLEN TRITICUM AESTIVUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WESTERN WHEAT POLLEN pascopyrum smithii pollen PASCOPYRUM SMITHII POLLEN PASCOPYRUM SMITHII POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ALFALFA POLLEN medicago sativa pollen MEDICAGO SATIVA POLLEN MEDICAGO SATIVA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SWEET CLOVER POLLEN melilotus albus pollen MELILOTUS ALBUS POLLEN MELILOTUS ALBUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SUGAR BEET POLLEN beta vulgaris pollen BETA VULGARIS POLLEN BETA VULGARIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WESTERN JUNE GRASS POLLEN koeleria macrantha pollen KOELERIA MACRANTHA POLLEN KOELERIA MACRANTHA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BROOMWEED POLLEN amphiachyris dracunculoides pollen AMPHIACHYRIS DRACUNCULOIDES POLLEN AMPHIACHYRIS DRACUNCULOIDES POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CARELESS WEED POLLEN amaranthus palmeri pollen AMARANTHUS PALMERI POLLEN AMARANTHUS PALMERI POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COCKLEBUR POLLEN xanthium strumarium pollen XANTHIUM STRUMARIUM POLLEN XANTHIUM STRUMARIUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN YELLOW CURLY DOCK POLLEN rumex crispus pollen RUMEX CRISPUS POLLEN RUMEX CRISPUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FIREBUSH KOCHIA POLLEN kochia scoparia pollen KOCHIA SCOPARIA POLLEN KOCHIA SCOPARIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GOLDENROD POLLEN solidago canadensis pollen SOLIDAGO CANADENSIS POLLEN SOLIDAGO CANADENSIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GREASEWOOD POLLEN sarcobatus vermiculatus pollen SARCOBATUS VERMICULATUS POLLEN SARCOBATUS VERMICULATUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GROUNDSEL TREE POLLEN baccharis halimifolia pollen BACCHARIS HALIMIFOLIA POLLEN BACCHARIS HALIMIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN NETTLE POLLEN urtica dioica pollen URTICA DIOICA POLLEN URTICA DIOICA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN LAMBS QUARTERS POLLEN chenopodium album pollen CHENOPODIUM ALBUM POLLEN CHENOPODIUM ALBUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BURWEED MARSHELDER POLLEN iva xanthifolia pollen IVA XANTHIFOLIA POLLEN IVA XANTHIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN NARROWLEAF MARSHELDER POLLEN iva angustifolia pollen IVA ANGUSTIFOLIA POLLEN IVA ANGUSTIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COMMON MUGWORT POLLEN artemisia vulgaris pollen ARTEMISIA VULGARIS POLLEN ARTEMISIA VULGARIS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ROUGH MARSHELDER POLLEN iva annua var. annua pollen IVA ANNUA VAR. ANNUA POLLEN IVA ANNUA VAR. ANNUA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SPINY PIGWEED POLLEN amaranthus spinosus pollen AMARANTHUS SPINOSUS POLLEN AMARANTHUS SPINOSUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ROUGH REDROOT PIGWEED POLLEN amaranthus retroflexus pollen AMARANTHUS RETROFLEXUS POLLEN AMARANTHUS RETROFLEXUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PIGWEED MIX, ROUGH/SPINY POLLEN amaranthus retroflexus pollen and amaranthus spinosus pollen AMARANTHUS RETROFLEXUS POLLEN AMARANTHUS RETROFLEXUS POLLEN AMARANTHUS SPINOSUS POLLEN AMARANTHUS SPINOSUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ENGLISH PLANTAIN POLLEN plantago lanceolata pollen PLANTAGO LANCEOLATA POLLEN PLANTAGO LANCEOLATA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FALSE BUR RAGWEED POLLEN ambrosia acanthicarpa pollen AMBROSIA ACANTHICARPA POLLEN AMBROSIA ACANTHICARPA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GIANT RAGWEED POLLEN ambrosia trifida pollen AMBROSIA TRIFIDA POLLEN AMBROSIA TRIFIDA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN STANDARDIZED SHORT RAGWEED POLLEN ambrosia artemisiifolia pollen AMBROSIA ARTEMISIIFOLIA POLLEN AMBROSIA ARTEMISIIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WESTERN RAGWEED POLLEN ambrosia psilostachya pollen AMBROSIA PSILOSTACHYA POLLEN AMBROSIA PSILOSTACHYA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN 3-RAGWEED MIX, GIANT/SHORT/WESTERN POLLEN ambrosia psilostachya pollen and ambrosia trifida pollen and ambrosia artemisiifolia pollen AMBROSIA PSILOSTACHYA POLLEN AMBROSIA PSILOSTACHYA POLLEN AMBROSIA TRIFIDA POLLEN AMBROSIA TRIFIDA POLLEN AMBROSIA ARTEMISIIFOLIA POLLEN AMBROSIA ARTEMISIIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RUSSIAN THISTLE POLLEN salsola kali pollen SALSOLA KALI POLLEN SALSOLA KALI POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COMMON BIG SAGEBRUSH POLLEN artemisia tridentata pollen ARTEMISIA TRIDENTATA POLLEN ARTEMISIA TRIDENTATA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SAGE MIX, COMMON/DARK-LEAVED/DRAGON/PASTURE POLLEN artemisia ludoviciana pollen and artemisia tridentata pollen and artemisia dracunculus pollen and artemisia frigida pollen ARTEMISIA LUDOVICIANA POLLEN ARTEMISIA LUDOVICIANA POLLEN ARTEMISIA TRIDENTATA POLLEN ARTEMISIA TRIDENTATA POLLEN ARTEMISIA DRACUNCULUS POLLEN ARTEMISIA DRACUNCULUS POLLEN ARTEMISIA FRIGIDA POLLEN ARTEMISIA FRIGIDA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PRAIRIE SAGE POLLEN artemisia frigida pollen ARTEMISIA FRIGIDA POLLEN ARTEMISIA FRIGIDA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ANNUAL SALTBUSH POLLEN atriplex wrightii pollen ATRIPLEX WRIGHTII POLLEN ATRIPLEX WRIGHTII POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SHADSCALE POLLEN atriplex confertifolia pollen ATRIPLEX CONFERTIFOLIA POLLEN ATRIPLEX CONFERTIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SOUR DOCK SHEEP SORREL POLLEN rumex acetosella pollen RUMEX ACETOSELLA POLLEN RUMEX ACETOSELLA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WATER HEMP POLLEN amaranthus tuberculatus pollen AMARANTHUS TUBERCULATUS POLLEN AMARANTHUS TUBERCULATUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WINGSCALE POLLEN atriplex canescens pollen ATRIPLEX CANESCENS POLLEN ATRIPLEX CANESCENS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ANNUAL WORMWOOD POLLEN artemisia annua pollen ARTEMISIA ANNUA POLLEN ARTEMISIA ANNUA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COMMON WORMWOOD POLLEN artemisia absinthium pollen ARTEMISIA ABSINTHIUM POLLEN ARTEMISIA ABSINTHIUM POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MEXICAN TEA POLLEN chenopodium ambrosioides pollen CHENOPODIUM AMBROSIOIDES POLLEN CHENOPODIUM AMBROSIOIDES POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DOCK MIX, SOUR SHEEP SORREL/YELLOW POLLEN rumex acetosella pollen and rumex crispus pollen RUMEX ACETOSELLA POLLEN RUMEX ACETOSELLA POLLEN RUMEX CRISPUS POLLEN RUMEX CRISPUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN STANDARDIZED RAGWEED MIX, GIANT/SHORT ambrosia trifida pollen and ambrosia artemisiifolia pollen AMBROSIA TRIFIDA POLLEN AMBROSIA TRIFIDA POLLEN AMBROSIA ARTEMISIIFOLIA POLLEN AMBROSIA ARTEMISIIFOLIA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DANDELION POLLEN taraxacum officinale pollen TARAXACUM OFFICINALE POLLEN TARAXACUM OFFICINALE POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SUNFLOWER POLLEN helianthus annuus pollen HELIANTHUS ANNUUS POLLEN HELIANTHUS ANNUUS POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ALTERNARIA TENUIS ALTERNATA alternaria alternata ALTERNARIA ALTERNATA ALTERNARIA ALTERNATA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ASPERGILLUS FUMIGATUS aspergillus fumigatus ASPERGILLUS FUMIGATUS ASPERGILLUS FUMIGATUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ASPERGILLUS GLAUCUS eurotium herbariorum EUROTIUM HERBARIORUM EUROTIUM HERBARIORUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ASPERGILLUS NIGER aspergillus niger var. niger ASPERGILLUS NIGER VAR. NIGER ASPERGILLUS NIGER VAR. NIGER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ASPERGILLUS TERREUS aspergillus terreus ASPERGILLUS TERREUS ASPERGILLUS TERREUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PULLULARIA PULLULANS aureobasidium pullulans var. pullutans AUREOBASIDIUM PULLULANS VAR. PULLUTANS AUREOBASIDIUM PULLULANS VAR. PULLUTANS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BOTRYTIS CINEREA botrytis cinerea BOTRYTIS CINEREA BOTRYTIS CINEREA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CANDIDA MONILA ALBICANS candida albicans CANDIDA ALBICANS CANDIDA ALBICANS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CEPHALOSPORIUM ACREMONIUM acremonium strictum ACREMONIUM STRICTUM ACREMONIUM STRICTUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CEPHALOTHECIUM ROSEUM trichothecium roseum TRICHOTHECIUM ROSEUM TRICHOTHECIUM ROSEUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CHAETOMIUM GLOBOSUM chaetomium globosum CHAETOMIUM GLOBOSUM CHAETOMIUM GLOBOSUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CLADOSPORIUM FULVUM passalora fulva PASSALORA FULVA PASSALORA FULVA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CURVULARIA SPICIFERA cochliobolus spicifer COCHLIOBOLUS SPICIFER COCHLIOBOLUS SPICIFER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN EPICOCCUM NIGRUM epicoccum nigrum EPICOCCUM NIGRUM EPICOCCUM NIGRUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN EPIDERMOPHYTON FLOCCOSUM epidermophyton floccosum EPIDERMOPHYTON FLOCCOSUM EPIDERMOPHYTON FLOCCOSUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FUSARIUM VASINFECTUM OXYSPORUM fusarium oxysporum vasinfectum FUSARIUM OXYSPORUM VASINFECTUM FUSARIUM OXYSPORUM VASINFECTUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FUSARIUM SOLANI haematonectria haematococca HAEMATONECTRIA HAEMATOCOCCA HAEMATONECTRIA HAEMATOCOCCA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GEOTRICHUM CANDIDUM geotrichum candidum GEOTRICHUM CANDIDUM GEOTRICHUM CANDIDUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HELMINTHOSPORIUM SATIVUM cochliobolus sativus COCHLIOBOLUS SATIVUS COCHLIOBOLUS SATIVUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HORMODENDRUM CLADOSPORIUM CLADOSPORIOIDES cladosporium cladosporioides CLADOSPORIUM CLADOSPORIOIDES CLADOSPORIUM CLADOSPORIOIDES SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MUCOR PLUMBEUS mucor plumbeus MUCOR PLUMBEUS MUCOR PLUMBEUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MUCOR RACEMOSUS mucor racemosus MUCOR RACEMOSUS MUCOR RACEMOSUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN NEUROSPORA SITOPHILA neurospora sitophila NEUROSPORA SITOPHILA NEUROSPORA SITOPHILA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN NIGROSPORA SPHAERICA khuskia oryzae KHUSKIA ORYZAE KHUSKIA ORYZAE SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PENICILLIUM NOTATUM CHRYSOGENUM penicillium chrysogenum var. chrysogenum PENICILLIUM CHRYSOGENUM VAR. CHRYSOGENUM PENICILLIUM CHRYSOGENUM VAR. CHRYSOGENUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PHOMA DESTRUCTIVA phoma destructiva PHOMA DESTRUCTIVA PHOMA DESTRUCTIVA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RHIZOPUS NIGRICANS rhizopus stolonifer RHIZOPUS STOLONIFER RHIZOPUS STOLONIFER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RHODOTORULA MUCILAGINOSA rhodotorula mucilaginosa RHODOTORULA MUCILAGINOSA RHODOTORULA MUCILAGINOSA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SPONDYLOCLADIUM ATROVIRENS helminthosporium solani HELMINTHOSPORIUM SOLANI HELMINTHOSPORIUM SOLANI SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN STEMPHYLIUM SARCINIFORME stemphylium sarciniforme STEMPHYLIUM SARCINIFORME STEMPHYLIUM SARCINIFORME SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TRICHODERMA LIGNORUM trichoderma viride TRICHODERMA VIRIDE TRICHODERMA VIRIDE SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TRICHOPHYTON MENTAGROPHYTES trichophyton mentagrophytes TRICHOPHYTON MENTAGROPHYTES TRICHOPHYTON MENTAGROPHYTES SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TRICHOPHYTON RUBRUM trichophyton rubrum TRICHOPHYTON RUBRUM TRICHOPHYTON RUBRUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN TRICHOPHYTON TONSURANS trichophyton tonsurans TRICHOPHYTON TONSURANS TRICHOPHYTON TONSURANS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN VERTICILLIUM ALBO ATRUM verticillium albo-atrum VERTICILLIUM ALBO-ATRUM VERTICILLIUM ALBO-ATRUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN BERMUDA GRASS SMUT ustilago cynodontis USTILAGO CYNODONTIS USTILAGO CYNODONTIS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CORN SMUT ustilago maydis USTILAGO MAYDIS USTILAGO MAYDIS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN JOHNSON GRASS SMUT sporisorium cruentum SPORISORIUM CRUENTUM SPORISORIUM CRUENTUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN WHEAT RUST puccinia graminis PUCCINIA GRAMINIS PUCCINIA GRAMINIS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COTTON SEED FOR DIAGNOSTIC USE ONLY cotton seed COTTON SEED COTTON SEED SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FLAX SEED FOR DIAGNOSTIC USE ONLY flax seed FLAX SEED FLAX SEED SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HOUSE DUST house dust HOUSE DUST HOUSE DUST SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN KAPOK ceiba pentandra fiber CEIBA PENTANDRA FIBER CEIBA PENTANDRA FIBER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN ORRIS ROOT iris germanica var. florentina root IRIS GERMANICA VAR. FLORENTINA ROOT IRIS GERMANICA VAR. FLORENTINA ROOT SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN PYRETHRUM tanacetum cinerariifolium flower TANACETUM CINERARIIFOLIUM FLOWER TANACETUM CINERARIIFOLIUM FLOWER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN SILK bombyx mori fiber BOMBYX MORI FIBER BOMBYX MORI FIBER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN COTTON LINTERS cotton fiber COTTON FIBER COTTON FIBER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CATTLE HAIR AND EPITHELIA bos taurus hair and bos taurus skin BOS TAURUS HAIR BOS TAURUS HAIR BOS TAURUS SKIN BOS TAURUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DOG HAIR AND EPITHELIA canis lupus familiaris hair and canis lupus familiaris skin CANIS LUPUS FAMILIARIS HAIR CANIS LUPUS FAMILIARIS HAIR CANIS LUPUS FAMILIARIS SKIN CANIS LUPUS FAMILIARIS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN CHICKEN FEATHERS gallus gallus feather GALLUS GALLUS FEATHER GALLUS GALLUS FEATHER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN DUCK FEATHERS anas platyrhynchos feather ANAS PLATYRHYNCHOS FEATHER ANAS PLATYRHYNCHOS FEATHER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GOOSE FEATHERS anser anser feather ANSER ANSER FEATHER ANSER ANSER FEATHER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FEATHER MIX, CHICKEN/DUCK/GOOSE gallus gallus feather and anas platyrhynchos feather and anser anser feather GALLUS GALLUS FEATHER GALLUS GALLUS FEATHER ANAS PLATYRHYNCHOS FEATHER ANAS PLATYRHYNCHOS FEATHER ANSER ANSER FEATHER ANSER ANSER FEATHER SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GUINEA PIG HAIR AND EPITHELIA cavia porcellus hair and cavia porcellus skin CAVIA PORCELLUS HAIR CAVIA PORCELLUS HAIR CAVIA PORCELLUS SKIN CAVIA PORCELLUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HAMSTER HAIR AND EPITHELIA mesocricetus auratus skin MESOCRICETUS AURATUS SKIN MESOCRICETUS AURATUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HOG HAIR AND EPITHELIA sus scrofa hair and sus scrofa skin SUS SCROFA HAIR SUS SCROFA HAIR SUS SCROFA SKIN SUS SCROFA SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HORSE HAIR AND DANDER equus caballus hair and equus caballus skin EQUUS CABALLUS HAIR EQUUS CABALLUS HAIR EQUUS CABALLUS SKIN EQUUS CABALLUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MOUSE HAIR AND EPITHELIA mus musculus skin MUS MUSCULUS SKIN MUS MUSCULUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RABBIT HAIR AND EPITHELIA oryctolagus cuniculus hair and oryctolagus cuniculus skin ORYCTOLAGUS CUNICULUS HAIR ORYCTOLAGUS CUNICULUS HAIR ORYCTOLAGUS CUNICULUS SKIN ORYCTOLAGUS CUNICULUS SKIN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN FIRE ANT solenopsis invicta SOLENOPSIS INVICTA SOLENOPSIS INVICTA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN AMERICAN COCKROACH periplaneta americana PERIPLANETA AMERICANA PERIPLANETA AMERICANA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN GERMAN COCKROACH blatella germanica BLATELLA GERMANICA BLATELLA GERMANICA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN HOUSEFLY FOR DIAGNOSTIC USE ONLY musca domestica MUSCA DOMESTICA MUSCA DOMESTICA SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN MOSQUITO FOR DIAGNOSTIC USE ONLY aedes taeniorhynchus AEDES TAENIORHYNCHUS AEDES TAENIORHYNCHUS SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RINKEL MOLD MIX A aspergillus fumigatus and botrytis cinerea and chaetomium globosum and epicoccum nigrum and fusarium oxysporum vasinfectum and cochliobolus sativus and neurospora sitophila and mucor plumbeus and phoma exigua var. exigua and penicillium chrysogenum var. chrysogenum and aureobasidium pullulans var. pullutans and rhizopus stolonifer and rhodotorula mucilaginosa and saccharomyces cerevisiae and geotrichum candidum ASPERGILLUS FUMIGATUS ASPERGILLUS FUMIGATUS BOTRYTIS CINEREA BOTRYTIS CINEREA CHAETOMIUM GLOBOSUM CHAETOMIUM GLOBOSUM EPICOCCUM NIGRUM EPICOCCUM NIGRUM FUSARIUM OXYSPORUM VASINFECTUM FUSARIUM OXYSPORUM VASINFECTUM COCHLIOBOLUS SATIVUS COCHLIOBOLUS SATIVUS NEUROSPORA SITOPHILA NEUROSPORA SITOPHILA MUCOR PLUMBEUS MUCOR PLUMBEUS PHOMA EXIGUA VAR. EXIGUA PHOMA EXIGUA VAR. EXIGUA PENICILLIUM CHRYSOGENUM VAR. CHRYSOGENUM PENICILLIUM CHRYSOGENUM VAR. CHRYSOGENUM AUREOBASIDIUM PULLULANS VAR. PULLUTANS AUREOBASIDIUM PULLULANS VAR. PULLUTANS RHIZOPUS STOLONIFER RHIZOPUS STOLONIFER RHODOTORULA MUCILAGINOSA RHODOTORULA MUCILAGINOSA SACCHAROMYCES CEREVISIAE SACCHAROMYCES CEREVISIAE GEOTRICHUM CANDIDUM GEOTRICHUM CANDIDUM SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RINKEL MOLD MIX B trichothecium roseum and passalora fulva and cochliobolus spicifer and myrothecium verrucaria and trichophyton schoenleinii and mycogone nigra and neurospora crassa and khuskia oryzae and paecilomyces variotii and microascus brevicaulis and helminthosporium solani and pleospora tarda and streptomyces griseus and trichoderma viride TRICHOTHECIUM ROSEUM TRICHOTHECIUM ROSEUM PASSALORA FULVA PASSALORA FULVA COCHLIOBOLUS SPICIFER COCHLIOBOLUS SPICIFER MYROTHECIUM VERRUCARIA MYROTHECIUM VERRUCARIA TRICHOPHYTON SCHOENLEINII TRICHOPHYTON SCHOENLEINII Mycogone nigra Mycogone nigra NEUROSPORA CRASSA NEUROSPORA CRASSA KHUSKIA ORYZAE KHUSKIA ORYZAE PAECILOMYCES VARIOTII PAECILOMYCES VARIOTII MICROASCUS BREVICAULIS MICROASCUS BREVICAULIS HELMINTHOSPORIUM SOLANI HELMINTHOSPORIUM SOLANI PLEOSPORA TARDA PLEOSPORA TARDA STREPTOMYCES GRISEUS STREPTOMYCES GRISEUS TRICHODERMA VIRIDE TRICHODERMA VIRIDE SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN RINKEL MOLD MIX C absidia capillata and acrothecium robustum and microsporum audouinii and microsporum canis and apiospora montagnei and phycomyces blakesleeanus and sporotrichum pruinosum and stachybotrys chartarum and syncephalastrum racemosum and tetracoccosporium paxianum and verticillium albo-atrum and thermomyces lanuginosus and trichosporon cutaneum Absidia capillata Absidia capillata ACROTHECIUM ROBUSTUM ACROTHECIUM ROBUSTUM MICROSPORUM AUDOUINII MICROSPORUM AUDOUINII MICROSPORUM CANIS MICROSPORUM CANIS APIOSPORA MONTAGNEI APIOSPORA MONTAGNEI PHYCOMYCES BLAKESLEEANUS PHYCOMYCES BLAKESLEEANUS SPOROTRICHUM PRUINOSUM SPOROTRICHUM PRUINOSUM STACHYBOTRYS CHARTARUM STACHYBOTRYS CHARTARUM SYNCEPHALASTRUM RACEMOSUM SYNCEPHALASTRUM RACEMOSUM TETRACOCCOSPORIUM PAXIANUM TETRACOCCOSPORIUM PAXIANUM VERTICILLIUM ALBO-ATRUM VERTICILLIUM ALBO-ATRUM THERMOMYCES LANUGINOSUS THERMOMYCES LANUGINOSUS Trichosporon cutaneum Trichosporon cutaneum SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN OSAGE ORANGE VAR BOIS DARC POLLEN maclura pomifera pollen MACLURA POMIFERA POLLEN MACLURA POMIFERA POLLEN SODIUM CHLORIDE SODIUM BICARBONATE WATER GLYCERIN LAKE TROUT trout TROUT TROUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER TUNA tuna TUNA TUNA SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER TURKEY FOOD turkey TURKEY TURKEY SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER BLACK WALNUT FOOD black walnut BLACK WALNUT BLACK WALNUT SODIUM CHLORIDE SODIUM BICARBONATE GLYCERIN WATER"],"spl_unclassified_section":["Allergenic Extracts Directions for Use"],"storage_and_handling":["STORAGE To insure the maximum potency of bulk extract and extract dilutions, it is recommended that they be maintained at a temperature of 2 to 8 degrees Celsius. Do not freeze. Do not use after the expiration date shown on the vial label."],"version":"5","warnings":["WARNINGS See boxed WARNINGS at the beginning of this information sheet. Do not administer allergenic extract injections intravenously. Patients should always be observed for at least 20 to 30 minutes after any skin test or injection. Concentrated allergenic extracts should be diluted with Sterile Diluent for Allergenic Extract prior to use for intradermal testing and for immunotherapy preparation. Systemic reactions may occur infrequently and may range from mild exaggeration of the patient’s allergic symptoms to urticaria, rhinitis, conjunctivitis, angioedema, cough, wheezing, fainting, pallor, bradycardia, hypotension, or even, in extremely sensitive individuals, to anaphylactic shock and death. Have epinephrine 1:1,000 readily available in case of a reaction. Emergency measures and personnel trained for medical emergencies should be immediately available in the event of a life-threatening reaction. Patients with unstable asthma or steroid dependent asthmatics and patients with underlying cardiovascular disease are at greater risk. Patients taking beta-blocker medication may not respond to the usual dose of epinephrine. Diagnostic testing as well as immunotherapy should be temporarily withheld from patients or the dose reduced until cause of reaction is evaluated by prescribing physician if any of the following conditions exist: (1) severe symptoms of rhinitis and/or asthma, (2) infection or flu accompanied by fever, (3) exposure to excessive amounts of clinically relevant allergen prior to a scheduled injection, and (4) systemic reaction to previous injection."]}