USDA Approved for Sublingual Administration
Not Just
Another Choice
for SLIT—
The Only
Choice that
Leaves You
in Complete
Control
GREER Extracts and
GREER Pharmacy Custom Prescriptions
®
TM
®
Real Choices. Complete Control.
TM
Two Choices for Complete Control
All the Tools You Need to Compound SLIT Prescriptions...
GREER® Extracts™
Wide selection of allergenic extracts available in aqueous and
glycerinated formulations
• USDA approved for sublingual administration
• Multiple sizes and strengths available to meet your practice needs
• More than 98% of stocked products shipped the same or next business day1
• Suggested dosing guidelines
50% Glycerin Saline from GREER®
50% glycerin saline has many benefits:
• Patient Acceptance
• The sweet taste of glycerin makes sublingual extracts more palatable to
pets2 and enhances patient acceptance.3
• Efficiency
• More efficient 100 mL vial
•S
helf life of six years from the manufacturing date
• Stability
•E
xtends extract mixture potency life—even in fungal and insect extract
mixes that contain protein-degrading enzymes4,5
• The stability provided by glycerin is thought to prevent the denaturation
of the allergen proteins and inhibit enzymatic activity in extract mixtures.4
• Potency
• Preserves potency of concentrated allergenic extracts effectively throughout
their shelf life under appropriate storage, shipping, and administration
conditions6,7
SLIT Delivery System
Pump and Vial Delivery System for SLIT Prescriptions
15 mL nonsterile amber glass vial with three metered-dose, screw-on pump options:
• 200 µL snub nose
• 50 µL hook nose
• 140 µL hook nose
GREER® Optimix® Extract Mixing Syringes
Mixing Syringes Optimal for SLIT
• Quickly draw thick/viscous extracts
• Optimal for glycerinated extracts and 50% Glycerin Saline, which are more
thick and viscous than aqueous extracts and other diluents
• Nondetachable, 23 gauge needle design reduces dead space
GREER® Optimix® Syringe is manufactured by Terumo and distributed by GREER®.
...Or Let GREER Pharmacy Do it for You.
®
GREER® Pharmacy Services
GREER® Pharmacy offers:
• Total disclosure of prescription contents and strengths
• Custom SLIT prescriptions delivered to your office
• Over 30 years of allergy immunotherapy prescription experience
• Licensed specialty pharmacy that specializes in the compounding of veterinary
allergy immunotherapy prescriptions
• SLIT prescriptions compounded to meet veterinarian-specified instructions
• GREER® pharmacists available for personal consultation
Sublingual Immunotherapy (SLIT)
Suggested SLIT Prescription Formulation
Veterinarians may consider formulating SLIT prescriptions according to the following steps.*
Materials used:GREER® Extracts™
(2) 15 mL nonsterile amber glass vials
50% Glycerin Saline
Disposable syringes
Divide 5 by the number of allergens to be used. The result is the
volume in milliliters of each allergen to be injected into each 15 mL vial.
STEP 1
Examples: 2
allergens: 2.5 mL of each (5 ÷ 2 = 2.5 mL)
3 allergens: 1.66 mL of each (5 ÷ 3 = 1.66 mL)
12 allergens: 0.42 mL of each (5 ÷ 12 = 0.42 mL)
STEP 2
Draw up the appropriate amount of each allergen and inject it into each
of the 15 mL vials. Each vial now contains 5 mL of allergenic extract.
STEP 3
Add 5 mL of 50% Glycerin Saline to each of the 15 mL vials.
FINAL CONCENTRATION
20,000 PNU/mL if using 40,000 PNU/mL extracts
10,000 PNU/mL if using 20,000 PNU/mL extracts
* The suggested steps to formulate a prescription for patient treatment vials are based on the process used by GREER® Pharmacy.
Please see package insert at
www.greerlabs.com>Veterinary Allergy>Package Insert.
Mixing and Dosing Information
Suggested SLIT Dosage Schedule
The client can be provided with the two 15 mL prescription vials along with
the two metered-dose pumps (50 µL and 140 µL) and instructed to increase the dose
through build-up and maintenance according to the schedule that you provide.
Veterinarians may consider the SLIT dosage schedule below.
Suggested
Build-Up
Phase
Suggested
Maintenance
Phase
Week 1
One (1) pump of the BLUE (50 µL) pump under the
tongue once daily
Week 2
Two (2) pumps of the BLUE (50 µL) pump under the
tongue once daily
Week 3
Replace the BLUE pump with the WHITE (140 µL) pump.
One (1) pump of the WHITE (140 µL) pump once daily
under the tongue.
E
L
P
SAM
If the patient completes Week 3 above, continue once daily at this
dose on an ongoing basis.
Every patient is different, so a smaller dose may be better for some
patients. Once the patient reaches the maximum tolerated dose,
continue that dose daily on an ongoing basis.
Extracts
TM
USDA Approved for Sublingual Administration
Real Choices. Complete Control. — You Decide
TM
•E
xtensive line of extracts to meet your needs for SLIT or SCIT administration
•S
upport for using SLIT in your practice, including:
– Sample SLIT dosages and schedules
– Licensed pharmacists available for individual consultation
–M
edical & Scientific Affairs team to answer questions and provide
technical resources
•C
ompound in your office or order custom prescriptions from GREER® Pharmacy
•D
iluents (50% Glycerin Saline, Normal Saline, Buffered Saline) available in a variety
of vial sizes
•C
hoices of sterile empty vials, nonsterile amber vials and pumps, syringes, and
syringe trays to meet the unique needs of your practice
The Unsurpassed Quality and Service You Expect from GREER
®
•G
REER Service Team, including Pharmacists, Customer Care Specialists, and
Medical & Scientific Affairs Specialists, to customize solutions for your practice
•R
igorous quality control—from collection/cultivation through final shipment
• More than 98% of stocked products shipped the same or next business day1
For more information about GREER® Extracts™ for SLIT and
real choices for complete control, reach out to GREER®.
877.777.1080 • [email protected] • www.greerlabs.com
References:
1. Data on File. GREER Laboratories, Inc. 2013.
2. Glycerine: an overview. ACIScience website. http://www.aciscience.org/docs/Glycerine_-_an_overview.pdf. Published 1990.
Accessed January 29, 2013.
3. de Araujo IE. Multiple reward layers in food reinforcement. In: Gottfried JA, ed. Neurobiology of Sensation and Reward.
Boca Raton, FL: CRC Press; 2011.
4. Plunkett G. Stability of allergen extracts used in skin testing and immunotherapy. Curr Opin Otolaryngol Head Neck Surg.
June 2008;16(3):285-291.
5. Grier TJ, LeFevre DM, Duncan EA, Esch RE. Stability of standardized grass, dust mite, cat, and short ragweed allergens after
mixing with mold or cockroach extracts. Ann Allergy Asthma Immunol. August 2007;99(2):151-160.
6. Van Metre TE, Jr., Rosenberg GL, Vaswani SK, Ziegler SR, Adkinson NF. Pain and dermal reaction caused by injected glycerin
in immunotherapy solutions. J Allergy Clin Immunol. May 1996;97(5):1033-1039.
7. Nelson HS. Effect of preservatives and conditions of storage on the potency of allergy extracts. J Allergy Clin Immunol.
January 1981;67(1):64-69.
GREER Veterinary Allergy
PO Box 800
639 Nuway Circle NE
Lenoir, NC 28645
877.777.1080
www.greerlabs.com
© GREER 2014.
All Rights Reserved.
MPN 120913V984 1.14 1K