2018 / 2019 Allergen Order Form - navamedic.com€¦ · NA33 bisphenol A epoxy resin 1 P NA56 quaternium 15 2 P NA08 p-tert-butylphenol formaldehyde resin 1 P NA101 ethyl hexyl glycerol

2018 / 2019 Allergen Order Form

CONTACT PERSON *Required fi elds

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HOW TO PLACE AN ORDER

1. Enter contact person, shipping, billing and payment information.

2. To order INDIVIDUAL allergens, enter the number of allergens to order in the “qty” column. To order a COMPLETE series, category or grouping, enter the number of allergens to order in the “qty” column in the top gray row.

3. To place your order, save the completed form and email it to [email protected] or fax it to 866-903-2672.

SERIES: the allergens are listed as recommended by the designated research groups.

GROUPINGS: the allergens are grouped by occupational or exposure source with preselected concentrations based on recommendations from international research groups and comprehensive literature review.

CATEGORIES: the allergens are all listed by product type (may contain multiple concentrations of a single allergen).

720 28th Street NE, Suite #210Calgary, AB T2A6R3PHONE: 866.903.2671 | FAX: 866.903.2672 | EMAIL: [email protected]

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1

SKU test substance %, vehicle qty

series AC: Core Allergen Series Complete AC series: 80 allergens

NA52 nickel sulfate hexahydrate 2.5 P

NA89 amerchol L101 50 P

NA51 neomycin sulfate 20 P

NA54 potassium dichromate 0.25 P

NA31 DMDM hydantoin 1 PNA38 fragrance mix

eugenol 1% ...............................................................................PF133geraniol 1% ...............................................................................PF134cinnamic aldehyde 1% ...............................................................NA19cinnamic alcohol 1% .................................................................PF129amylcinnamic aldehyde 1%hydroxycitronellal 1% ................................................................PF135isoeugenol 1% ..........................................................................PF137oakmoss absolue 1% ................................................................PF138

8 P

NA24 colophony 20 PNA53 paraben mix [B]

methyl-p-hydroxybenzoate 3% ................................................. AP100propyl-p-hydroxybenzoate 3% .................................................. AP105butyl-p-hydroxybenzoate 3% ...................................................... AP81ethyl-p-hydroxybenzoate 3% ...................................................... AP92

12 P

AP124 methylisothiazolinone 0.2 W

NA12 balsam of peru (myroxylon pereirae resin) 25 P

NA35 ethylenediamine dihydrochloride 1 P

NA21 cobalt (II) chloride hexahydrate 1 P

NA08 p-tert-butylphenol formaldehyde resin 1 P

NA33 bisphenol A epoxy resin 1 PNA18 carba mix

1,3-diphenylguanidine (DPG) 1% ..............................................RC265zinc bis(diethyldithiocarbamate) 1% ......................................... ST162zinc bis(dibutyldithiocarbamate) 1% .........................................RC268

3 P

NA15 black rubber mixN-dimethyl-1, C-butyl-N-phenyl-p-phenylenediamine (DMBPPD) 0.25%diphenyl-p-phenylenediamine (DPPD) 0.25% ...........................RC274N-isopropyl-N-phenyl-p-phenylenediamine (IPPD) 0.1% ........... ST168

0.6 P

NA09 methylchloroisothiazolinone/methylisothiazolinone 0.01 W

NA56 quaternium 15 2 P

ST177 methyldibromo glutaronitrile (MDBGN) 0.5 P

NA07 p-phenylenediamine 1 P

NA37 formaldehyde 1 WNA48 mercapto mix [A]

n-cyclohexyl-2-benzothiazyl-sulfenamide 0.333%dibenzothiazyl disulfide 0.333%morpholinyl mercaptobenzothiazole 0.333%

1 P

NA03 2-bromo-2-nitropropane-1,3-diol (bronopol™) 0.5 PNA60 thiuram mix [A]

tetramethyl thiuram monosulfide (TMTM) 0.25% ......................RC285tetramethylthiuram disulfide 0.25% ..........................................RC284tetraethylthiuram disulfide (disulfiram) 0.25% ..........................RC283dipentamethylenethiuram disulfide 0.25% ................................RC276

1 P

NA01 diazolidinyl urea (Germall ® I I) 1 P

NA13 benzocaine 5 P

NA61 tixocortol-21-pivalate 1 P

MC254 gold sodium thiosulfate 0.5 P

NA43 imidazolidinyl urea (Germall ® 115) 2 P

NA16 budesonide 0.1 P

NA93 hydrocortisone-17-butyrate 1 P

NA05 2-mercaptobenzothiazole 1 P

NA11 bacitracin 20 P


NA70 fragrance mix IIcoumarin 2.5%lyral 2.5%citronellol 0.5%farnesol 2.5%citral 1%alpha-hexylcinnamic aldehyde 5%

14 P

NA83 disperse blue mix (124/106)disperse blue-124 0.5%disperse blue-106 0.5%

1 P

NA47 lidocaine-HCl 15 P

NA55 propylene glycol 30 W

AP98 iodopropynyl butylcarbamate 0.2 P

EM405 polymyxin B sulfate 3 P

NA22 cocamidopropyl betaine 1 WNA88 mixed dialkyl thioureas

diethylthiourea 0.5%dibutylthiourea 0.5%

1 P

NA75 dimethylaminopropylamine (DMAPA) 1 W

NA72 2-hydroxyethyl methacrylate (HEMA) 2 P

NA80 oleamidopropyl dimethylamine 0.1 E

NA74 decyl glucoside 5 P

NA49 methyl methacrylate 2 P

NA81 lavandula angustifolia oil (lavender oil) 2 P

NA19 cinnamic aldehyde 1 P

NA87 dl alpha tocopherol 100

NA34 ethyl acrylate 0.1 P

NA58 tea tree oil, oxidized 5 P

AP84 chlorhexidine digluconate 0.5 W

NA71 propolis 10 P

NA06 4-chloro-3,5-xylenol (PCMX) 1 P

NA85 2-hydroxy-4-methoxybenzophenone (oxybenzone) 10 P

NA62 tosylamide formaldehyde resin 10 PNA57 sesquiterpenelactone mix (2 ml)

alantolactone 0.033%costunolide 0.033%dehydrocostuslactone 0.033%

0.1 P

NA23 coconut diethanolamide (cocamide DEA) 0.5 P

EE367 4-chloro-3-cresol (PCMC) 1 P

AP77 benzalkonium chloride 0.1 P

SS509 benzophenone-4 2 P

AP107 sodium benzoate 5 P

AP108 sorbic acid 2 P

NA65 cananga odorata (ylang ylang I) 2 PNA25 compositae mix

tanacetum vulgare 1%arnica montana 0.5%parthenolide 1%chamomilla romana 2.5%achillea millefolium 1%

6 P

PG316 ethyleneurea, melamine formaldehyde mixethyleneurea 2.5%melamine formaldehyde resin 2.5%

5 P

EE357 sorbitan sesquioleate 20 P

RC265 1,3-diphenylguanidine (DPG) 1 P

ST164 cetylstearylalcohol 20 P

NA101 ethyl hexyl glycerol 5 P

CS499 triamcinolone acetonide 1 P

NA20 clobetasol-17-propionate 1 P

NA10 amidoamine (stearamidopropyl dimethylamine) 0.1 W

NA90 ethyl cyanoacrylate (2 ml) 10 P

CL438 phenoxyethanol 1 P

2018 / 2019 ALLERGEN ORDER FORM: SERIES

Liquid In Tube Volatile | P: petrolatum W: water E: ethanol 2


DC325 disperse orange-3 1 P

AP78 benzoic acid 5 P

EE347 butylhydroxytoluene (BHT) 2 P

SS501 2-ethylhexyl-4-methoxycinnamate (octinoxate) 10 P

AP118 benzyl alcohol 5 P

series ACS: Core Allergen Reduced SeriesConsists of 48 allergens to supplement T.R.U.E. TEST for the Core Allergen Series

Complete ACS series: 48 allergensNA31 DMDM hydantoin 1 PNA70 fragrance mix II

coumarin 2.5%lyral 2.5%citronellol 0.5%farnesol 2.5%citral 1%alpha-hexylcinnamic aldehyde 5%

14 P


1 P





NA22 cocamidopropyl betaine 1 W NA88 mixed dialkyl thioureas


1 P


NA72 2-hydroxyethyl methacrylate 2 P










NA71 propolis 10 P



NA62 tosylamide formaldehyde resin 10 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P




SS509 benzophenone 4 2 P



NA65 cananga odorata (ylang ylang I) 2 PNA25 compositae mix


6 P


PG316 ethyleneurea, melamine formaldehyde mixethyleneurea 2.5%melamine formaldehyde resin 2.5%

5 P















series NA: North American Standard SeriesComplete NA series: 70 allergens

NA13 benzocaine 5 P


NA24 colophony 20 P


NA75 dimethylaminopropylamine (DMAPA) 1 WNA70 fragrance mix II


14 P

NA89 amerchol L101 50 PNA18 carba mix


3 P

NA51 neomycin sulfate 20 PNA60 thiuram mix [A]


1 P

NA37 formaldehyde 1 W


NA33 bisphenol A epoxy resin 1 P



NA101 ethyl hexyl glycerol 5 PNA15 black rubber mix

N-dimethyl-1, C-butyl-N-phenyl-p-phenylenediamine (DMBPPD) 0.25%diphenyl-p-phenylenediamine (DPPD) 0.25% ...........................RC274N-isopropyl-N-phenyl-p-phenylenediamine (IPPD) 0.1% ........... ST168

0.6 P





NA31 DMDM hydantoin 1 P

NA43 imidazolidinyl urea (Germall® 115) 2 P





NA88 mixed dialkyl thioureasdiethylthiourea 0.5%dibutylthiourea 0.5%

1 P

AP125 methylchloroisothiazolinone/methylisothiazolinone 0.02 WNA53 paraben mix [B]


12 P

NA19 cinnamic aldehyde 1 PNA38 fragrance mix


8 P


NA03 2-bromo-2-nitropropane-1,3-diol (bronopol™) 0.5 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P


EE374 lauryl glycoside (2 ml)



ST173 parthenolide (2 ml) 0.1 P


EM408 sodium disulfite 1 PNA50 methyldibromo glutaronitrile/phenoxyethanol

(MDBGN/PE-Euxyl K 400)2 P



NA44 iodopropynyl butylcarbamate 0.5 P


SS506 benzophenone-4 (sulisobenzone) 10 P

NA62 tosylamide formaldehyde resin 10 P





CL431 benzisothiazolinone 0.1 PDC348 textile dye mix [B]

disperse blue-35 1%disperse yellow-3 1% ............................................................. DC329disperse orange-1 1%disperse red-1 1%....................................................................DC326disperse red-17 1%..................................................................DC328disperse blue-106 0.3% ...........................................................DC340disperse blue-124 0.3% ...........................................................DC998

5.6 P

NA71 propolis 10 P


NA96 propylene glycol 100


NA22 cocamidopropyl betaine 1 W



HD476 ammonium persulfate 2.5 P



NA25 compositae mixtanacetum vulgare 1%arnica montana 0.5%parthenolide 1%chamomilla romana 2.5%achillea millefolium 1%

6 P

AP126 chlorhexidine digluconate 1 W


NA65 cananga odorata (ylang ylang I) 2 P

NA73 carvone 5 P

CL437 octylisothiazolinone 0.025 P


PC626 hydroquinone 1 P

NA82 mentha piperita oil (peppermint oil) 2 P

series NAS: North American Standard Reduced SeriesConsists of 40 allergens to supplement T.R.U.E. TEST for the North American Standard Series

Complete NAS series: 40 allergensNA13 benzocaine 5 P

NA75 dimethylaminopropylamine (DMAPA) 1 WNA70 fragrance mix II


14 P



NA88mixed dialkyl thioureasdiethylthiourea 0.5%dibutylthiourea 0.5%

1 P


NA57sesquiterpenelactone mix (2 ml)alantolactone 0.033%costunolide 0.033%dehydrocostuslactone 0.033%

0.1 P


EE374 lauryl glycoside (2 ml) 3 P




EM408 sodium disulfite 1 P





SS506 benzophenone-4 (sulisobenzone) 10 P



CL431 benzisothiazolinone 0.1 PDC348 textile dye mix [B]

disperse blue-35 1% disperse yellow-3 1% ...............................................................DC329disperse orange-1 1% disperse red-1 1%....................................................................DC326disperse red-17 1%..................................................................DC328disperse blue-106 0.3% ...........................................................DC340disperse blue-124 0.3% ...........................................................DC998

5.6 P











NA23 coconut diethanolamide (cocamide DEA) 0.5 PNA25 compositae mix


6 P




NA73 carvone 5 P





series AU: Australian Baseline SeriesComplete AU series: 59 allergens

ST167 nickel sulfate hexahydrate 5 P


NA24 colophony 20 P

AP87 diazolidinyl urea 2 P


ST160 2-mercaptobenzothiazole 2 P


ST170 potassium dichromate 0.5 P

NA64 lanolin alcohol 30 P





NA43 imidazolidinyl urea (Germall® 115) 2 PNA53 paraben mix [B]


12 P

NA60 thiuram mix [A]tetramethyl thiuram monosulfide (TMTM) 0.25% ......................RC285tetramethylthiuram disulfide 0.25% ..........................................RC284tetraethylthiuram disulfide (disulfiram) 0.25% ..........................RC283dipentamethylenethiuram disulfide 0.25% ................................RC276

1 P

ST181 mercapto mix [C]N-cyclohexyl-2-benzothiazylsulphenamide 0.5%dibenzothiazyldisulfide 0.5%2-mercaptobenzothiazole 0.5%morpholinyl mercaptobenzothiazole 0.5% ................................RC294

2 P

NA38 fragrance mixeugenol 1% ...............................................................................PF133geraniol 1% ...............................................................................PF134cinnamic aldehyde 1% ...............................................................NA19cinnamic alcohol 1% .................................................................PF129amylcinnamic aldehyde 1%hydroxycitronellal 1% ................................................................PF135isoeugenol 1% ..........................................................................PF137oakmoss absolue 1% ................................................................PF138

8 P


0.6 P

AP125 methylchloroisothiazolinone/methylisothiazolinone 0.02 W


NA22 cocamidopropyl betaine 1 WNA57 sesquiterpenelactone mix (2 ml)


0.1 P


14 P



AP106 quaternium 15 1 P


NA13 benzocaine 5 P


CL441 propylene glycol 5 P



ST164 cetylstearylalcohol 20 PNA25 compositae mix


6 P


DC341 basic red 46 1 P

AP85 chloroacetamide 0.2 PNA88 mixed dialkyl thioureas


1 P


AP90 DMDM hydantoin 2 WNA18 carba mix


3 P

NA92 dl-limonene (dipentene) 2 P




ST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 PNA83 disperse blue mix (124/106)

disperse blue-124 0.5%disperse blue-106 0.5%

1 P


CS500 betamethason-17,21 dipropionate 0.5 P

ST163 bufexamac 5 P



NA03 2-bromo-2-nitropropane-1,3-diol (bronopol™) 0.5 P

CS506 betamethasone-17-valerate 1 P

NA72 2-hydroxyethyl methacrylate 2 P








series EU: European Baseline Series Complete EU series: 30 allergens


NA07 p-phenylenediamine 1 PNA60 thiuram mix [A]


1 P



NA13 benzocaine 5 P


AP86 clioquinol 5 P

NA24 colophony 20 PST169 paraben mix [A]

methyl-p-hydroxybenzoate 4%propyl-p-hydroxybenzoate 4%butyl-p-hydroxybenzoate 4%ethyl-p-hydroxybenzoate 4%

16 P

ST168 N-isopropyl-N'-phenyl-p-phenylenediamine (IPPD) 0.1 P

NA64 lanolin alcohol 30 PST181 mercapto mix [C]

N-cyclohexyl-2-benzothiazylsulphenamide 0.5%dibenzothiazyldisulfide 0.5%2-mercaptobenzothiazole 0.5%morpholinyl mercaptobenzothiazole 0.5% ................................RC294

2 P





NA94 formaldehyde 2 WNA38 fragrance mix


8 P

NA57 sesquiterpenelactone mix (2 ml)alantolactone 0.033%costunolide 0.033%dehydrocostuslactone 0.033%

0.1 P


NH451 primin (2 ml) 0.01 P


CS497 budesonide 0.01 P

CS498 tixocortol-21-pivalate 0.1 P

ST177 methyldibromo glutaronitrile (MDBGN) 0.5 PNA70 fragrance mix II


14 P

ST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 P

AP124 methylisothiazolinone 0.2 WDC342 textile dye mix

disperse blue-35 1%disperse yellow-3 1% ...............................................................DC329disperse orange-1 1%disperse orange-3 1% ..............................................................DC325disperse red-1 1%....................................................................DC326disperse red-17 1%..................................................................DC328disperse blue-106 0.3%disperse blue-124 0.3%

6.6 P


series IC: International Baseline SeriesComplete IC series: 32 allergens




CS497 budesonide 0.01 PNA18 carba mix


3 P



NA24 colophony 20 PNA25 compositae mix


6 P





8 P


14 P


ST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 P




2 P






NA52 nickel sulfate hexahydrate 2.5 PST169 paraben mix [A]


16 P


NA56 quaternium 15 2 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P


1 P






series JP: Japanese Standard SeriesComplete JP series: 23 allergens

NA21 cobalt (II) chloride hexahydrate 1 PNA15 black rubber mix


0.6 P


NA52 nickel sulfate hexahydrate 2.5 PST181 mercapto mix [C]


2 P

RC290 dithiocarbamate mixdimethyldithiocarbamic acid zinc salt 0.5%diethyldithiocarbamic acid zinc salt 0.5%di-N-butyldithiocarbamic acid zinc salt 0.5%N-ethyl-N-phenyldithiocarbamic acid zinc salt 0.5%

2 P

LA524 caine mix [C]benzocaine 5% ...........................................................................NA13cinchocaine-HCl 1%procaine-HCl 1% ...................................................................... LA526

7 P



NA24 colophony 20 PPF155 fragrance mix [A]

eugenol 1% ...............................................................................PF133geraniol 1% ...............................................................................PF134cinnamic aldehyde 1% ...............................................................NA19cinnamic alcohol 1% .................................................................PF129amylcinnamic aldehyde 1%hydroxycitronellal 1% ................................................................PF135isoeugenol 1% ..........................................................................PF137sandalwood oil 1%

8 P

AP112 paraben mix [C]methyl p-hydroxybenzoate 3% ................................................. AP100propyl p-hydroxybenzoate 3% .................................................. AP105butyl p-hydroxybenzoate 3% ...................................................... AP81benzyl p-hydroxybenzoate 3% .................................................. AP121ethyl p-hydroxybenzoate 3% ...................................................... AP92

15 P





NH451 primin (2 ml) 0.01 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P


EM409 thimerosal 0.1 P

NA 37 formaldehyde 1 W


EE353 petrolatum 100


series BB: British Baseline Series Complete BB series: 41 allergens


NA51 neomycin sulfate 20 PNA60 thiuram mix [A]


1 P

NA07 p-phenylenedia 1 P

NA21 cobalt (II) chloride hexahydrate 1 PLA525 caine mix [A]

benzocaine 5% ...........................................................................NA13cinchocaine-HCl 1%tetracaine-HCl 1% ................................................................... DM229

7 P


NA24 colophony 20 PMS988 oxyquinoline mix

chlorquinaldol 3%clioquinol 3%

6 P





2 P

NA33 bisphenol A epoxy resin 1 PST169 paraben mix [A]


16 P

NA08 p-tert-butylphenol formaldehyde resin 1 PNA38 fragrance mix


8 P





NA89 amerchol L101 50 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P




AA418 fusidic acid sodium salt 2 P











NA18 carba mix1,3-diphenylguanidine (DPG) 1% ..............................................RC265zinc bis(diethyldithiocarbamate) 1% ......................................... ST162zinc bis(dibutyldithiocarbamate) 1% .........................................RC268

3 P


14 P


1 P

ST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 PNA25 compositae mix


6 P



series SIDAPA: Italian Baseline Series Complete SIDAPA series: 29 allergens



NA13 benzocaine 5 P



NA24 colophony 20 P



CS508 hydrocortisone-21-acetate 1 P


ST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 PST181 mercapto mix [C]


2 P






ST167 nickel sulfate hexahydrate 5 PST169 paraben mix [A]


16 P


ST170 potassium dichromate 0.5 PNA70 fragrance mix II


14 P



8 P



EE357 sorbitan sesquioleate 20 PDC342 textile dye mix


6.6 P


1 P


category AA: Antibiotics / AntimycoticsComplete AA category: 25 allergens

AA414 ampicillin 5 P


MS391 chloramphenicol 5 P

AA415 chlorotetracycline-HCl 1 P

MS372 chlorquinaldol 5 P

AP86 clioquinol 5 P

AA426 clotrimazole 1 P

AA417 erythromycin 1 P

AA427 erythromycin 2 P

AA428 framycetin sulfate 10 P


AA419 gentamicin sulfate 20 P

AA420 kanamycin sulfate 10 P

MS376 mafenide 10 P

MS380 metronidazol 1 P


MS381 nitrofurazone 1 P

AA421 nystatin 2 PMS988 oxyquinoline mix

chlorquinaldol 3%clioquinol 3%

6 P

AA422 oxytetracycline 3 P


AA423 streptomycin sulfate 5 P

AA424 sulfanilamide 5 P

AA425 tetracycline-HCl 2 P

AA999 tobramycin 20 P

2018 / 2019 ALLERGEN ORDER FORM: SERIES & CATEGORIES



category AP: Antimicrobials / PreservativesComplete AP category: 79 allergens


CL431 benzisothiazolinone 0.1 P

MS398 1,2-benzisothiazoline-3-one, sodium salt 0.1 P


AP79 benzotriazole 1 P

NA67 benzyl alcohol 1 P


AP121 benzyl-p-hydroxybenzoate 3 P

CL432 benzylhemiformal 1 P


AP81 butyl-p-hydroxybenzoate 3 P

EE346 butylhydroxyanisole (BHA) 2 P


AP82 cetalkonium chloride 0.1 P

AP996 cetrimide 0.05 W

AP83 cetylpyridinium chloride 0.1 P





AP85 chloroacetamide 0.2 P


NA01 diazolidinyl urea (Germall® II) 1 P

AP89 dichlorophene 0.5 PCL433 4,4-dimethyl-1,3-oxazolidine/3,4,4-trimethyl-1,

3-oxazolidine (Bioban™ CS 1135)

1 P

AP997 dimethylfumarate 0.01 P

ST159 dimethylfumarate 0.5 P

AP90 DMDM hydantoin 2 W


AP91 dodecyl gallate 0.3 P

AP92 ethyl-p-hydroxybenzoate 3 P

CL434 7-ethylbicyclooxazolidine (Bioban™ CS 1246) 1 P



NA39 glutaraldehyde 1 P

AP93 glutaraldehyde 0.3 P

AP95 glyoxal trimeric dihydrate 1 P

CL430 1,3,5-tris(2-hydroxyethyl)-hexahydrotriazine (Grotan BK) 1 P

AP75 2-hydroxymethyl-2-nitro-1,3-propanediol 1 P


AP97 iodoform 5 P



AP100 methyl-p-hydroxybenzoate 3 P






NA50 methyldibromo glutaronitrile/phenoxyethanol (MDBGN/PE-Euxyl K 400)

2 P

AP99 methyldibromo glutaronitrile/phenoxyethanol (MDBGN/PE-Euxyl K 400)

1 P

AP113 methyldibromo glutaronitrile/phenoxyethanol (MDBGN/PE-Euxyl K 400)

0.1 P

CL435 methylene-bis(methyloxazolidin) 1 P


AP124 methylisothiazolinone 0.2 WAP119 (nitrobutyl)morpholine/(ethylnitrotrimethylene)

dimorpholine (Bioban™ P 1487)

1 P

EE352 octyl gallate 0.3 P

CL437 octylisothiazolinone 0.025 PST169 paraben mix [A]


16 P

NA53 paraben mix [B]methyl-p-hydroxybenzoate 3% ................................................. AP100propyl-p-hydroxybenzoate 3% .................................................. AP105butyl-p-hydroxybenzoate 3% ...................................................... AP81ethyl-p-hydroxybenzoate 3% ...................................................... AP92

12 P

AP112 paraben mix [C]methyl p-hydroxybenzoate 3% ................................................. AP100propyl p-hydroxybenzoate 3% .................................................. AP105butyl p-hydroxybenzoate 3% ...................................................... AP81benzyl p-hydroxybenzoate 3% .................................................. AP121ethyl p-hydroxybenzoate 3% ...................................................... AP92

15 P


AP101 phenylmercuric acetate 0.05 P

AP102 phenylmercuric nitrate 0.01 P

AP103 polyvidone iodine 10 W

AP104 propyl gallate 0.5 P

AP105 propyl-p-hydroxybenzoate 3 P






CL439 sodium-2-pyridinethiol-1-oxide (sodium-omadine) 0.1 W


EE358 tert-butylhydroquinone 1 P


AP109 thimerosal 1 P

PA460 3,4,4'-triclocarban 1 P

AP110 triclosan 2 P

AP111 zinc pyrithione 0.1 P

category CS: CorticosteroidsComplete CS category: 28 allergens

CS490 amcinonide 0.1 P

CS999 betamethasone-17-valerate 0.1 E

CS491 betamethasone-17-valerate 0.12 P


CS997 betamethasone-17,21-dipropionate 0.1 E




2018 / 2019 ALLERGEN ORDER FORM: CATEGORIES



CS998 clobetasol-17-propionate 0.1 E

CS492 clobetasol-17-propionate 0.25 P

NA20 clobetasol-17-propionate 1 PCS507 corticosteroide mix

hydrocortisone 21-acetate 1%hydrocortisone-17-butyrate 1% ..................................................NA93budesonide 0.01% .....................................................................NA16

2.01 P

NA68 desoximetasone 1 P

CS493 dexamethasone 0.5 P

CS502 dexamethasone-21-phospate 1 P

CS496 hydrocortisone 1 P

CS494 hydrocortisone-17-butyrate 0.1 P

NA69 hydrocortisone-17-butyrate 1 E



CS996 methylprednisolone aceponate 0.1 E

CS995 mometasone furoate 0.1 E

CS993 prednicarbate 1 E

CS503 prednisolone 1 P



CS505 triamcinolone acetonide 0.1 P


category DA: Dietary AdditivesComplete DA category: 22 allergens

FA180 amaranth 0.1 W

FA181 aspartame 0.1 W

FA182 azorubine 0.1 E

FA183 benzoic acid 1 E

FA184 brilliant black 0.1 W

FA185 butylhydroxyanisole (BHA) 2 E

FA186 butylhydroxytoluene (BHT) 1 E

FA187 carmine 0.5 W

FA188 cochineal red 1 W

FA189 erythrosin-B 0.25 E

FA190 formic acid 1 W

FA191 patent blue-VF 0.25 W

FA192 pectin 1 W

FA193 quinoline yellow 0.1 W

FA194 saccharin 0.1 W

FA195 sodium alginate 1 W

FA196 sodium diphosphate 1 W

FA198 sodium formiate 2 W

FA199 sodium glutamate 1 W

FA200 sodium nitrite 2 W

FA202 sorbic acid 2 E

FA204 tartrazine 1 W


category DC: Dyes / ColorantsComplete DC category: 27 allergens

DC320 4-aminoazobenzene 1 P

DC336 p-aminodiphenylamine 0.25 P

HD475 3-aminophenol 1 P

DC321 p-aminophenol 1 P

DC322 aniline 1 P


DC339 bismark brown R 0.5 P

NA91 carmine 2.5 P

DC324 disperse blue-3 1 P

DC340 disperse blue-106 (2 ml) 1 P

DC998 disperse blue-124 1 PNA83 disperse blue mix (124/106)

disperse blue-124 0.5%disperse blue-106 0.5%

1 P


DC326 disperse red-1 1 P



DC329 disperse yellow-3 1 P


DC333 metanil yellow (acid yellow 36) 1 P

DC334 methyl violet 0.5 P

DC335 naphthol-AS 1 P

HD478 o-nitro-p-phenylenediamine 1 P


HD483 p-toluenediamine 1 P

HD479 p-toluenediamine sulfate 1 PDC342 textile dye mix


6.6 P

DC348 textile dye mix [B]disperse blue-35 1%disperse yellow-3 1% ............................................................. DC329disperse orange-1 1%disperse red-1 1%....................................................................DC326disperse red-17 1%..................................................................DC328disperse blue-106 0.3% ...........................................................DC340disperse blue-124 0.3% ...........................................................DC998

5.6 P

category EE: External Agents / EmulsifiersComplete EE category: 34 allergens



EM999 carboxymethyl cellulose sodium 2 P




EE349 cold cream 100


EE350 diethanolamine 2 P

EE366 dimethylaminopropylamine 1 P






EE373 hexylene glycol 10 W

EE351 isopropylmyristate 10 P





EE354 polyethylene glycol ointment 100

EE355 polyethylene glycol-400 100

CL441 propylene glycol 5 P

EE356 propylene glycol 20 W



EE370 sodium lauryl sulfate (SLS) 0.5 P

EE372 sodium lauryl sulfate (SLS) 0.25 W

EE369 sorbitan monooleate (span™ 80) 5 P


EE365 stearyl alcohol 30 P

EE359 triethanolamine 2.5 P

EE360 tween 40 10 P

EE361 tween 80 10 P

EE362 wool alcohols ointment 100

EE363 wool fat 30 P

category EM: Eye MedicamentsComplete EM category: 26 allergens

EM396 atropine sulfate 1 W


EM999 carboxymethyl cellulose sodium 2 P




AA415 chlorotetracycline-HCl 1 P


MS373 dexpanthenol 5 P

MS374 diclofenac 5 P

MS394 diclofenac 2.5 P

EM399 disodium edetate 1 P



EM400 iododeoxyuridine 1 P

AA420 kanamycin sulfate 10 P


AA422 oxytetracycline 3 P

EM410 phenylephrine hydrochloride 10 W

EM411 pilocarpine hydrochloride 1 W

EM404 pindolol 2 P




DM229 tetracaine-HCl 1 P



category LA: Local AnestheticsComplete LA category: 12 allergens

LA999 articane hydrochloride 1 P

NA13 benzocaine 5 PLA525 caine mix [A]

benzocaine 5% ...........................................................................NA13cinchocaine-HCl 1%tetracaine-HCl 1% ................................................................... DM229

7 P

LA524 caine mix [C]benzocaine 5% ...........................................................................NA13cinchocaine-HCl 1%procaine-HCl 1% ...................................................................... LA526

7 P

LA520 cinchocaine-HCl 5 P

NA26 cinchocaine-HCl 2.5 P


LA521 mepivacaine-HCl 1 P

LA522 polidocanol 3 P

LA523 procaine-HCl 2 P

LA526 procaine-HCl 1 P

DM229 tetracaine-HCl 1 P

category MC: Metal CompoundsComplete MC category: 62 allergens

MC262 aluminum hydroxide 10 P

DM232 amalgam (Hg 2.5%, Ag 1.7%, Cu 0.3%, Sn 0.4%, Zn 0.025%) 5 P

DM233 amalgam alloying metals (Ag 13.9%, Cu 2.4%, Sn 3.5%, Zn 0.2%) 20 P

DM216 ammoniated mercury 1 P

MC270 ammonium heptamolybdate 1 P

MC239 ammonium heptamolybdate 2 W

DM217 ammonium tetrachloroplatinate 0.25 P

MC986 antimony chloride 1 P

MC269 beryllium(II) sulfate 1 W

MC241 cadmium chloride 0.5 P

MC976 cadmium sulfate 2 P

MC243 chromium (III) chloride 1 P

MC242 chromium(III) sulfate hydrate 0.5 P


MC244 cobalt (II) sulfate 2.5 P

DM222 copper sulfate pentahydrate 1 W

MC245 copper sulfate pentahydrate 2 P

MC264 ferric chloride 2 W

MC247 ferrous sulfate 5 P

MC248 gallium oxide 1 P

MC992 germanium(IV) chloride 2 P

MC979 gold acid chloride trihydrate 0.1 P

DM228 gold sodium thiosulfate 0.25 P


MC249 indium (III) chloride 1 P

MC988 iridium(III) chloride 1 P

MC995 manganese chloride 0.5 P

MC977 manganese oxide 10 P

MC987 magnesium chloride 2 P




MC250 mercury 0.5 P

DM999 mercury-(II)-chloride 0.1 P

MC263 molybdenum (V) chloride 0.5 P

MC994 neodymium (III) chloride 1 P



MC981 niobium (V)-chloride 0.2 P

DM226 palladium chloride 1 P

MC997 platinum chloride (platinum tetrachloride) 1 P



DM227 potassium dicyanoaurate 0.002 P

MC251 potassiumchromate-(III)-sulfate 2 W

MC998 rhodium chloride 2 P

MC252 ruthenium 0.1 P

MC993 samarium(III) chloride 1.5 P

MC253 silver colloidal 0.1 P

MC266 silver nitrate 1 W

MC985 strontium chloride 2 P

MC255 tantal 1 P

MC984 tellurium chloride 2 P

DM230 tin (II) chloride 0.5 P

MC260 titanium 1 P

MC256 titanium (IV) oxide 0.1 P

MC238 tungstic acid, sodium salt dihydrate 2 W

MC983 ytterbium sulfate 2 P

MC982 yttrium oxide 2 P

MC267 vanadium pentoxide 10 P

MC996 wolfram 5 P

MC257 zinc chloride 1 P

MC258 zinc powder 1 P

MC268 zinc sulfate 1 P

MC259 zirconium (IV) oxide 0.1 P

category MS: Medicinal SubstancesComplete MS category: 40 allergens

MS370 acetylsalicylic acid 10 P

MS994 aminophenazone 10 P

ST163 bufexamac 5 P

SS991 benzydamine hydrochloride 2 P

MS371 camphor 1 P

MS987 chloramphenicol 2 E

NA229 chlorhexidine diacetate 0.5 W

EM398 chlorphenamine maleate 5 P

PA463 chlorpromazine-HCl 1 P

MS393 cyanocobalamin (2 ml) 10 P

SS987 dexketoprofen 1 P

MS373 dexpanthenol 5 P

MS394 diclofenac 2.5 P

MS374 diclofenac 5 P

SS989 etofenamate 2 P

SS990 fenofibrate 10 P


MS997 ibuprofen 5 P

MS375 indomethacin 1 P

SS992 ketoprofen 1 P

MS996 ketoprofen 2.5 P

MS378 metamizol 1 P

MS998 naproxen 5 P

MS382 paracetamol 10 P

MS989 penicillamine 1 P

MS993 phenacetine 10 P

MS395 phenazone 5 P

MS383 phenylbutazone 10 P

SS988 piketoprofen 1 P

MS396 piperazine 1 P

MS992 piroxicam 1 P

PA467 promethazine-HCl 2 P

EM406 propanolol-HCl 2 P

MS385 propyphenazone 1 P

PA468 quinidine sulfate 1 P

MS386 quinine sulfate 25 P

PG329 salicylamide 2 P

MS387 salicylic acid 5 P

MS389 sulphur, precipitated 10 P

MS397 thiamin nitrate 10 P

AP120 thymol 1 P

category NP: Natural Origin & PlantsComplete NP category: 22 allergens

PG298 abietic acid 10 P

EE364 abitol 10 P

NH445 alpha pinene 15 P

NH456 atranorin (2 ml) 0.1 P

NH448 coal tar 5 P

NA24 colophony 20 PNA25 compositae mix


6 P

NH999 diallyl disulfide 1 PNA233 lichen acid mix (2 ml)

atranorin 0.1% .........................................................................NH456usnic acid 0.1% .......................................................................NH454evernic acid 0.1%

0.3 P



NH450 pine tar 3 P

NH451 primin (2 ml) 0.01 P

NA71 propolis 10 PNA57 sesquiterpenelactone mix (2 ml)


0.1 P

NA78 shellac 20 E



NH452 tolu balsam 20 P




NH453 turpentine peroxide 03 P

NH454 usnic acid 0.1 PNH455 wood tar mix

birch tar 3%juniper wood oil 3%beech tar 3%canadian balsam 3%

12 P

category PF: Perfumes / FlavorsComplete PF category: 66 allergens

PF125 alpha-amylcinnamic aldeyhde 1 P

PF164 alpha-hexylcinnamic aldehyde 10 P

PF172 alpha-isomethylionone 1 P

PF157 amylcinnamic alcohol 1 P

PF158 anisyl alcohol 1 P


PF126 benzaldehyde 5 P

NA67 benzyl alcohol 1 P


PF127 benzyl cinnamate 5 P

PF128 benzyl salicylate 1 P

PF159 benzylbenzoate 1 P


NA73 carvone 5 P

PF139 cedar oil 10 P

PF129 cinnamic alcohol 1 P


PF160 citral 2 P

PF130 citronellal 2 P

PF161 citronellol 1 P

PF162 coumarin 5 P

PF133 eugenol 1 P

PF163 farnesol 5 PPF155 fragrance mix [A]

eugenol 1% ...............................................................................PF133geraniol 1% ...............................................................................PF134cinnamic aldehyde 1% ...............................................................NA19cinnamic alcohol 1% .................................................................PF129amylcinnamic aldehyde 1%hydroxycitronellal 1% ................................................................PF135isoeugenol 1% ..........................................................................PF137sandalwood oil 1%

8 P

PF156 fragrance mix [B]eugenol 1% ...............................................................................PF133geraniol 1% ...............................................................................PF134cinnamic aldehyde 1% ...............................................................NA19cinnamic alcohol 1% .................................................................PF129alpha-amylcinnamicaldehyde 1%hydroxycitronellal 1% ................................................................PF135isoeugenol 1% ..........................................................................PF137oakmoss absolue 1% ................................................................PF138

8 P


8 P


14 P


PF134 geraniol 1 P

PF135 hydroxycitronellal 1 P

PF137 isoeugenol 1 P

PF167 jasmine absolute 1 P

NA76 jasminum officinale oil (jasminum grandiflorum) 2 P

PF996 laurel leaves oil (laurus nobilis) 2 P


PF132 d-limonene 2 P

NA79 d-limonene 3 P


PF176 linalool 10 PST161 lyral (4-(4-hydroxy-4-methyl pentyl)-3-cyclohexene-1-carboxaldehyde) 5 P

NA77 majantole 5 P


MS377 menthol 1 P

MS379 methyl salicylate 2 P

PF177 methylheptincarbonat 1 P

PA465 musk ambrette 5 P

PF178 narcissus poeticus absolute 2 P

PF140 neroli oil 2 P

PF166 neroli oil 5 P

PF138 oakmoss absolue 1 P

PF141 oil of bergamot 2 P

PF142 oil of cinnamon 0.5 P

PF143 oil of cloves 2 P

PF144 oil of eucalyptus 2 P

PF146 oil of lemon 2 P

PF147 oil of lemongrass 2 P

PF170 oil of patchouli 10 P

PF149 oil of rose 0.5 P

PF150 oil of rosemary 0.5 P

ST172 oil of turpentine 10 P

PF165 orange oil 2 P

PF151 phenyl salicylate 1 P

PF152 salicylaldehyde 2 P

PF168 sandalwood oil 10 P

PF171 tree moss 1 P

PF153 vanillin 10 P

PF175 ylang-ylang (I+II) Öl 10 P

category PG: Plastics / GluesComplete PG category: 57 allergens


PG320 1,4-butanediolediglycidyl ether 0.25 P

PG332 4-tert buylcatechol 0.25 P

PG333 trimethylhexane-1,6 diamine 0.5 P

PG322 butyl glycidyl ether 0.25 P

PG305 cresyl glycidyl ether 0.25 P

PG296 4,4'-diaminodiphenylmethane 0.5 P

PG323 diethylenetriamine 1 P





RC278 hexamethylenetetramine 1 P

PG321 1,6-hexanediolediglycidyl ether 0.25 P

PG304 isophorone diamine 0.5 P

PG328 phenyl glycidyl ether 0.25 P

PG313 triethylenetetramine 0.5 P

DM219 BIS-GMA (bisphenol A-glycidyl methacrylate) 2 P

DM221 bisphenol-A-dimethacrylate 2 P

DM211 1,3-butandiol-dimethacrylate 2 P

PG319 1,4-butandioldimethacrylate (BUDMA) 2 P

PG300 butylacrylate 0.1 P



DM224 ethyleneglycol dimethacrylate (EGDMA) 2 P

PG295 2-ethylhexyl acrylate 0.1 P

PG324 ethylmethacrylate 2 P

DM212 2-hydroxy-ethylacrylate 0.1 P

DM210 2-hydroxyethyl methacrylate (HEMA) 1 P


DM213 2-hydroxypropyl-methacrylate 2 P


PG327 pentaerythritoltriacrylate (PETA) 0.1 P

PG330 tetrahydrofurfuryl methacrylate 2 P

DM231 triethyleneglycol dimethacrylate (TEGDMA) 2 P

DM223 diurethane dimethacrylate 2 P

PG303 diphenylmethane-4,4'-diisocyanate 1 P

PG310 toluene 2,4-diisocyanate 1 P

NA08 p-tert-butylphenol formaldehyde resin 1 PPG316 ethyleneurea, melamine formaldehyde mix

ethyleneurea 2.5%melamine formaldehyde resin 2.5%

5 P

PG326 melamine formaldehyde resin 7 P

PG306 phenol-formaldehyde-resin 5 P

PG309 resorcinol-formaldehyde-resin 5 P


PG325 urea formaldehyde resin 10 P


DM218 benzoyl peroxide 1 P

DM220 bisphenol A 1 P

PG315 bisphenol F 1 P

PG297 4-tert-butylcatechol 1 P

PG308 p-tert-butylphenol 1 P

RC271 dibutylphthalate 5 P

PG301 diethylphthalate 5 P

NA27 dimethylol dihydroxyethyleneurea 4.5 W

PG302 dimethylphthalate 5 P

DM225 N,N-dimethyl-p-toluidine 2 P

PG299 bis(2-ethylhexyl)phthalate 5 P

PG312 tricresyl phosphate 5 P

PG314 triphenyl phosphate 5 P

PG999 epichlorhydrin 0.1 P


category RC: Rubber ChemicalsComplete RC category: 34 allergens


0.6 P

NA18 carba mix1,3-diphenylguanidine (DPG) 1% ..............................................RC265zinc bis(diethyldithiocarbamate) 1% ......................................... ST162zinc bis(dibutyldithiocarbamate) 1% .........................................RC268

3 P

RC281 n-cyclohexyl-2-benzothiazyl-sulfenamide 1 P

RC293 cyclohexylthiophtalimide 0.5 P

RC270 dibenzothiazyl disulfide 1 P

RC292 bis(dibenzyldithiocarbamato)zinc 1 P

RC272 dibutylthiourea 1 P

RC999 diethylthiourea 1 P

RC267 4,4'-dihydroxybiphenyl 0.1 P

RC276 dipentamethylenethiuram disulfide 0.25 P

RC274 diphenyl-p-phenylenediamine 0.25 P


RC275 diphenylthiourea 1 PRC290 dithiocarbamate mix

dimethyldithiocarbamic acid zinc salt 0.5%diethyldithiocarbamic acid zinc salt 0.5%di-N-butyldithiocarbamic acid zinc salt 0.5%N-ethyl-N-phenyldithiocarbamic acid zinc salt 0.5%

2 P

RC277 dodecyl mercaptan 0.1 P



RC279 hydroquinone monobenzylether 1 P

ST168 N-isopropyl-N-phenyl-p-phenylenediamine (IPPD) 0.1 PNA48 mercapto mix [A]

n-cyclohexyl-2-benzothiazyl-sulfenamide 0.333%dibenzothiazyl disulfide 0.333%morpholinyl mercaptobenzothiazole 0.333%

1 P

ST176 mercapto mix [B]N-cyclohexyl-2-benzothiazylsulfenamide 0.666%dibenzothiazyldisulfide 0.666%morpholinyl mercaptobenzothiazole 0.666%

2 P

ST181 mercapto mix [C]N-cyclohexyl-2-benzothiazylsulphenamide 0.5%dibenzothiazyldisulfide 0.5%2-mercaptobenzothiazole 0.5%morpholinyl mercaptobenzothiazole 0.5% ................................RC294

2 P

RC266 2-mercaptobenzimidazole 1 P



RC294 morpholinyl mercaptobenzothiazole 0.5 P

RC282 N-phenyl-ß-naphthylamine 1 P

RC283 tetraethylthiuram disulphide 0.25 P

RC285 tetramethyl thiuram monosulfide (TMTM) 0.25 P

RC284 tetramethylthiuram disulphide 0.25 P

RC286 thiourea 0.1 PNA60 thiuram mix [A]


1 P

RC268 zinc bis(dibutyldithiocarbamate) 1 P

ST162 zinc bis(diethyldithiocarbamate) 1 P




category ST: Supplemental AllergensComplete ST category: 17 allergens

SS504 p-aminobenzoic acid 10 P

PG334 p-tert.-Butylphenylglycidylether 0.25 P

NA210 tert.-butyl methoxydibenzoyl methane 5 P

MC980 cesium chloride 2 P

NA200 2-ethylhexyl-p-methoxycinnamate (octinoxate) 7.5 P

NA214 dioxybenzone 2 P

PG999 epichlorhydrin 0.1 P

AP76 4-hexyl-resorcinol 0.25 P

NA209 homosalate 5 P

SS996 homosalate 10 P

NA204 octisalate 5 P

SS995 octisalate 10 P

NA211 octocrylene 1 P

DC337 phenolphthalein 0.5 P

HD481 resorcinol 1 P

NA217 trolamine salicylate 5 PSS986 2-(2´-hydroxy-5´-methylphenyl)benzotriazole

(Drometrizole)10 P

grouping BA: BakeryComplete BA grouping: 20 allergens







PF129 cinnamic alcohol 1 P



PF133 eugenol 1 P

PF137 isoeugenol 1 P


MS377 menthol 1 P







PF153 vanillin 10 P

grouping CG: CosmeticsComplete CG grouping: 64 allergens

EE364 abitol 10 P







PF128 benzyl salicylate 1 P










AP86 clioquinol 5 P








NA35 ethylenediamine dihydrochloride 1 PNA38 fragrance mix


8 P


14 P



NA85 2-hydroxy-4-methoxy-benzophenone (oxybenzone) 10 P



EE351 isopropylmyristate 10 P







ST172 oil of turpentine 10 P

NA80 oleamidopropyl dimethylamine 0.1 ENA53 paraben mix [B]


12 P


PF151 phenyl salicylate 1 P





2018 / 2019 ALLERGEN ORDER FORM: CATEGORIES & GROUPINGS



NA78 shellac 20 E







EE365 stearyl alcohol 30 P


EE358 tert-butylhydroquinone 1 P




AP110 triclosan 2 P


EE361 tween 80 10 P

grouping CL: Cooling Lubricants (Metalworking)Complete CL grouping: 40 allergens



CL440 2-(2-aminoethoxy)ethanol (diglycolamine) 1 P

CL431 benzisothiazolinone 0.1 P


CL432 benzylhemiformal 1 P


PG308 p-tert-butylphenol 1 P





AP89 dichlorophene 0.5 P

EE350 diethanolamine 2 PCL433 4,4-dimethyl-1,3-oxazolidine/3,4,4-trimethyl-1,

3-oxazolidine (Bioban™ CS 1135)

1 P

CL434 7-ethylbicyclooxazolidine (Bioban™ CS 1246) 1 P




PC625 hydrazine sulfate 1 P







CL435 methylene-bis(methyloxazolidin) 1 P


CL436 monoethanolamine 2 P

RC294 morpholinyl mercaptobenzothiazole 0.5 PAP119 (nitrobutyl)morpholine/(ethylnitrotrimethylene)

dimorpholine (Bioban™ P 1487)

1 P








AP110 triclosan 2 P


ST162 zinc bis(diethyldithiocarbamate) 1 P

grouping CC: CorticosteroidsComplete CC grouping: 17 allergens

CS490 amcinonide 0.1 P





NA68 desoximetasone 1 P


CS502 dexamethasone-21-phospate 1 P

CS496 hydrocortisone 1 P



CS996 methylprednisolone aceponate 0.1 E

CS995 mometasone furoate 0.1 E

CS993 prednicarbate 1 E




grouping DP: Dental Screening PatientsComplete DP grouping: 30 allergens

DM232 amalgam (Hg 2.5%, Ag 1.7%, Cu 0.3%, Sn 0.4%, Zn 0.025%) 5 P

DM233 amalgam alloying metals (Ag 13.9%, Cu 2.4%, Sn 3.5%, Zn 0.2%) 20 P

DM216 ammoniated mercury 1 P






DM211 1,3-butandiol-dimethacrylate 2 P


NA73 carvone 5 P



NA24 colophony 20 P



PF133 eugenol 1 P



2018 / 2019 ALLERGEN ORDER FORM: GROUPINGS





MS377 menthol 1 P

MC250 mercury 0.5 P








grouping DT: Dental Screening Technicians/HCPsComplete DT grouping: 26 allergens










PG324 ethylmethacrylate 2 P

PF133 eugenol 1 P






PG326 melamine formaldehyde resin 7 P

MC250 mercury 0.5 P




PG327 pentaerythritoltriacrylate (PETA) 0.1 P





grouping EL: Eyelid DermatitisComplete EL grouping: 30 allergens




AP77 benzalkonium chloride 0.1 PNA15 black rubber mix


0.6 P






NA24 colophony 20 P






8 P






NA09 methylchloroisothiazinolone/methylisothiazinolone 0.01 W






NA78 shellac 20 E

EM409 thimerosal 0.1 PNA60 thiuram mix [A]


1 P


grouping FW: FootwearComplete FW grouping: 43 allergens

DC320 4-aminoazobenzene 1 P




PG315 bisphenol F 1 PNA15 black rubber mix


0.6 P


MC241 cadmium chloride 0.5 PNA18 carba mix


3 P


NA24 colophony 20 P


RC293 cyclohexylthiophtalimide 0.5 P

PG296 4,4'-diaminodiphenylmethane 0.5 P

RC271 dibutylphthalate 5 P




RC272 dibutylthiourea 1 P

RC999 diethylthiourea 1 P

ST159 dimethylfumarate 0.5 P


RC275 diphenylthiourea 1 P






RC277 dodecyl mercaptan 0.1 P



RC279 hydroquinone monobenzylether 1 P


PG326 melamine formaldehyde resin 7 PST181 mercapto mix [C]


2 P



NA09 methylchloroisothiazinolone/methylisothiazinolone 0.01 WNA88 mixed dialkyl thioureas


1 P




ST170 potassium dichromate 0.5 PNA60 thiuram mix [A]


1 P


PG325 urea formaldehyde resin 10 P

grouping HD: HairstylingComplete HD grouping: 33 allergens


DC336 p-aminodiphenylamine 0.25 P

HD475 3-aminophenol 1 P



HD482 ammonium thioglycolate 1 W













8 P


14 P

NA40 glyceryl monothioglycolate 1 P



EE374 lauryl gylcoside (2 ml) 3 P

NA09 methylchloroisothiazinolone/methylisothiazinolone 0.01 W

CL436 monoethanolamine 2 P


HD478 o-nitro-p-phenylenediamine 1 P



HD480 pyrogallol 1 P


HD484 resorcinol 2 P

HD483 p-toluenediamine 1 P

AP111 zinc pyrithione 0.1 P

grouping HP: Health Care ProfessionalsComplete HP grouping: 29 allergens


AP996 cetrimide 0.05 W





AP103 povidone iodine 10 WNA18 carba mix


3 P

NA48 mercapto mix [A]n-cyclohexyl-2-benzothiazyl-sulfenamide 0.333%dibenzothiazyl disulfide 0.333%morpholinyl mercaptobenzothiazole 0.333%

1 P

ST160 2-mercaptobenzothiazole 2 PNA88 mixed dialkyl thioureas


1 P


1 P














AP124 methylisothiazolinone* 0.2 WST169 paraben mix [A]


16 P




AP110 triclosan 2 PNA38 fragrance mix


8 P

grouping LU: Leg UlcerComplete LU grouping: 34 allergens













AP86 clioquinol 5 P

AP87 diazolidinyl urea 2 PNA38 fragrance mix


8 P


14 P

AA428 framycetin sulfate 10 P




MS381 nitrofurazone 1 P


ST169 paraben mix [A]methyl-p-hydroxybenzoate 4%propyl-p-hydroxybenzoate 4%butyl-p-hydroxybenzoate 4%ethyl-p-hydroxybenzoate 4%

16 P



AP103 povidone iodine 10 W

NA71 propolis 10 P







EE359 triethanolamine 2.5 PNH455 wood tar mix

birch tar 3%juniper wood oil 3%beech tar 3%canadian balsam 3%

12 P

grouping MI: Metal ImplantsComplete MI grouping: 29 allergens

MC262 aluminum hydroxide 10 P

MC270 ammonium heptamolybdate 1 P







MC249 indium(III) chloride 1 P

MC988 iridium(III) chloride 1 P



MC981 niobium (V)-chloride 0.2 P



MC266 silver nitrate 1 W

MC255 tantal 1 P

DM230 tin(II) chloride 0.5 P

MC260 titanium 1 P

MC256 titanium(IV) oxide 0.1 P

MC238 tungstic acid, sodium salt dihydrate 2 W

MC267 vanadium pentoxide 10 P

MC996 wolfram 5 P






MC259 zirconium (IV) oxide 0.1 P




grouping NS: Nail Technicians / ClientsComplete NS grouping: 8 allergens

DM210 2-hydroxyethyl methacrylate (HEMA) 1 P





DM212 2-hydroxy-ethylacrylate 0.1 P



grouping PA: PhotoallergensComplete PA grouping: 36 allergens

MS390 para-aminobenzoic acid 5 P

NH456 atranorin (2 ml) 0.1 P



PA462 bithionol 1 P

SS505 tert-butyl methoxydibenzoyl methane 10 P


PA463 chlorpromazine-HCl 1 PNA222 4-diethylamino-2-hydroxybenzoyl-benzoic acid

hexyl ester10 P

NA223 diethylhexyl butamido triazone 10 P

NA224 disodium phenyldibenzimidazole tetrasulfonate 10 P

SS500 2-ethylhexyl p-(dimethylamino)benzoate 10 P


NA220 bis-ethylhexyloxyphenol-methoxyphenyl triazine 10 PNA38 fragrance mix


8 P

PA464 hexachlorophene 1 P

NA206 2-hydroxy-4-methoxy-4-methyl benzophenone 10 P


SS507 isoamyl-4-methoxycinnamate 10 P

MS996 ketoprofen 2.5 PNA233 lichen acid mix (2 ml)

atranorin 0.1% .........................................................................NH456usnic acid 0.1% .......................................................................NH454evernic acid 0.1%

0.3 P

NA205 menthyl anthranilate (meradimate) 5 P

SS503 3,4-methyl benzylidene camphor 10 P

PA465 musk ambrette 5 P

SS982 octrocrylene 10 P

NA219 octyl triazone 10 P

PA466 phenylbenzimidazole-5-sulfonic acid 10 P

MS992 piroxicam 1 P

PA467 promethazine-HCl 2 P

PA468 quinidine sulfate 1 P

AA424 sulfanilamide 5 P

RC286 thiourea 0.1 P


NA221 tinosorb (methylene-bis-benzotriazolyl tetramethylbutylphenol) 10 P


AP110 triclosan 2 P

NH454 usnic acid 0.1 P

grouping PC: Photography ChemicalsComplete PC grouping: 19 allergens





EE350 diethanolamine 2 P

EM399 disodium edetate 1 P



PC625 hydrazine sulfate 1 P



MC251 potassiumchromate(III) sulfate 2 W

HD480 pyrogallol 1 P



PG312 tricresyl phosphate 5 P


PG314 triphenyl phosphate 5 P


grouping SS: SunscreensComplete SS grouping: 18 allergens

MS390 para-aminobenzoic acid 5 P


NA220 bis-ethylhexyloxyphenol-methoxyphenyl triazine 10 P

SS505 tert-butyl methoxydibenzoyl methane 10 PNA222 4-diethylamino-2-hydroxybenzoyl-benzoic acid

hexyl ester10 P

NA223 diethylhexyl butamido triazone 10 P

NA224 disodium phenyldibenzimidazole tetrasulfonate 10 P

SS500 2-ethylhexyl p-(dimethylamino)benzoate 10 P


NA206 hydroxy-4-methoxy-4-methyl benzophenone 10 P


SS507 isoamyl-4-methoxycinnamate 10 P

SS982 octocrylene 10 P

NA219 octyl triazone 10 P

NA205 menthyl anthranilate (meradimate) 5 P

SS503 3,4-methyl benzylidene camphor 10 P

PA466 phenylbenzimidazole-5-sulfonic acid 10 P

NA221 tinosorb (methylene-bis-benzotriazolyl tetramethylbutylphenol) 10 P




grouping TP: Tattoos / Permanent Make-UpComplete TP grouping: 30 allergens

NA78 shellac 20 E

EE355 polyethylene glycol-400 100







MC260 titanium 1 P


MC258 zinc powder 1 P

DM222 copper sulfate pentahydrate 1 W










MS398 1,2-benzisothiazoline-3-one, sodium salt 0.1 P







AP124 methylisothiazolinone 0.2 WST169 paraben mix [A]


16 P

grouping TD: Textile DyesComplete TD grouping: 14 allergens


DC339 bismark brown R 0.5 P











DC335 naphthol-AS 1 P


85621_0318 © 2018 SmartPractice Canada • All rights reserved. SmartPractice, allergEAZE and associated logos are trademarks of SmartHealth, Inc.



Documents

2018 / 2019 Allergen Order Form - navamedic.com€¦ · NA33 bisphenol A epoxy resin 1 P NA56 quaternium 15 2 P NA08 p-tert-butylphenol formaldehyde resin 1 P NA101 ethyl hexyl glycerol