Sublingual Immunotherapy Presctiption Formulation Environmental Allergens - Peds

Multi-Allergen Inhalant (R)
3 Month Supply
6Month Supply
Pre-Seasonal Inhalant (Y)
3 Month Supply: Order with Multi-Allergen if within 3 months of searson- specific start date below.
Test Results Multi-Inhalants Threshhold Treatment Dilution Vol (mL)
BLD SKIN 1 2 3 4 5 6 7 8 9 10 Std. Other
Tree Mix #11 1 2 3 4 5 6 7 8 9 10 .60
7 Std Grass Mix 1 2 3 4 5 6 7 8 9 10 .60
Common Weed Mix 1 2 3 4 5 6 7 8 9 10 .60
Ragweed Mix 1 2 3 4 5 6 7 8 9 10 .60
New Stock Fungi 1 2 3 4 5 6 7 8 9 10 .60
Fusarium 1 2 3 4 5 6 7 8 9 10 .60
Candida 1 2 3 4 5 6 7 8 9 10 .60
Pine Mix 1 2 3 4 5 6 7 8 9 10 .30
Mite D.p 1 2 3 4 5 6 7 8 9 10 .30
Mite D.f 1 2 3 4 5 6 7 8 9 10 .30
Oak Mix 1 2 3 4 5 6 7 8 9 10 .30
Birch Mix 1 2 3 4 5 6 7 8 9 10 .30
Alternaia
Alternata 		1 2 3 4 5 6 7 8 9 10 .30
Test Results Multi-Inhalants Threshhold Treatment Dilution Vol (mL)
BLD SKIN 1 2 3 4 5 6 7 8 9 10 Std. Other
Dog Hair,Dander 1 2 3 4 5 6 7 8 9 10 .30
Cat Pelt 1 2 3 4 5 6 7 8 9 10 .30
Cat Hair, Dander 1 2 3 4 5 6 7 8 9 10 .30
Hamster 1 2 3 4 5 6 7 8 9 10 .30
Guinea Pig 1 2 3 4 5 6 7 8 9 10 .30
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
PRESEASONAL START DATE DILUTION
11 Tree Mix
2
7 Std Grass Mix
2
PRESEASONAL START DATE DILUTION
Mite Mix
2
Mountain Cedar
2
PRESEASONAL START DATE DILUTION
Ragweed Mix
2
Common Weed Mix
2
DIRECTIONS FOR USE: 1 DOSE = 1 PUMP CYCLE
INHALANT: Take 1 dose under the tongue three times daily.
PRESEASONAL: Take 1 dose under the toungue once daily, increase by 1 dose daily until reaching 100 doses per day until finished. If mouth itching develops, continue that dose untill itching no longher. Then resume the increase of 1 dose per day untill you reach 10 doses per day.
OTHER: