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Dilution Tables Here are some common dilution strategies used when making treatment vials. 5 – Fold Dilution – 5 mL Vials – 1:20 w/v Glycerinated Extract: 1:2 Dilution – 10mL and 5mL Vials: Used for example, when you want to convert a 1:10 w/v into a 1:20 w/v or if you want to convert 10,000… read more

Intradermal Dilutions In early 2013, several allergen extract manufacturers decided to discontinue stock formulations of intradermal products. In place of this, it is recommended that you perform your own dilutions using the extract stock concentrations. Rationale for the discontinuation of intradermal strength products​ Allergen extracts that have been diluted to intradermal strength are known to… read more

Anaphylaxis Crash Cart In addition to the recommended routine supplies, every practice that intends to perform allergen immunotherapy must be supplied and trained for possible severe systemic reactions, such as anaphylaxis. Below is a list of recommended emergency supplies that should be stocked separately from the routine supplies. Modifications may be necessary depending on the… read more

Skin Testing Supplies Once you have reviewed the appropriate procedures, established your diagnostic panel, and ordered your supplies, you are ready to begin testing patients. Most practices will diagnose their patients by skin testing using glycerinated extracts and a sterile, disposable skin test device. Depending on the patient’s clinical history and the allergist’s training and… read more

Effect of Formulation on Stability Below is a figure that shows how expiration dating varies by formulation. For standardized products, these dates were established through FDA-approved testing methods. For non-standardized products, these dates were established by the FDA. For more information on extract formulation, please see the section on Extract Formulations Expiration dates for bulk… read more

Formulation Concern – Phenol Does phenol have a negative impact on extract stability? Many extracts contain phenol (0.4%) as a preservative. There have been some reports that phenol can impact the stability of allergenic extracts. However, more recent data has shown that phenol does not appear to have a significant impact on the long term… read more

Formulation Concern – Alum Does aluminum (alum) have a negative impact on patient health? Aluminum has been used as an adjuvant in numerous vaccines for over 70 years with no severe adverse effects reported. Despite suggestions, made decades ago, that alum may contribute to conditions such as Alzheimer’s disease or other neurological disorders, there has… read more