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Home  >  References References General References Used Throughout Stability References Painful Injection From 50% Glycerin FDA Standardization Major Allergen And Standardization Regional Relevance Of Allergens Cross-Reactivity Management Of Anaphylaxis Coring & Syringe Technique Skin Testing USP 797 References – Beyond Use Date, Pharmacy Compounding Rules Allergen Information General References Used Throughout Cox, L, et al.… read more

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

Dose Calculations for the Maintenance Vial Theformulabelowoffersasimplifiedmethodforcalculatingthevolumeofan extract to add based on the target dose selected. Importantly, thiscalculationcanbeusedforanypotencyunit(AU, BAU, PNU,

W/V

, or µg). V = 10T/E V: Volume to be drawn up from the manufacturer’s bulk concentrate and added to the patient’s vial T: Target maintenance dose in 0.5cc injection (e.g., 2000BAU, 1000PNU, 7.5µg Der… 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

How to Perform Dilutions Once you have prepared the patient’s treatment vial (e.g., Red Vial), you will need to perform a series of dilutions before you begin treatment. Subcutaneous allergen immunotherapy begins with a small dose of a highly dilute allergen solution and, over time, increases in volume and concentration until the maintenance dose has… read more

Dosing One of the primary objectives when mixing allergenic extracts is to prepare a patient’s treatment set in a way that ensures an optimal therapeutic dose of each allergen in the patient’s allergen extract vial. Therefore, the limiting step when mixing is deciding what volume of each allergen to add to a patient’s maintenance vial.… 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