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IMPORTANT PATIENT INFORMATION

T.R.U.E. TEST indicates that you have a contact allergy to thimerosal, an antiseptic and preservative also known as Merthiolate®, which is used in some cosmetics, topical medications, and vaccines.

Contact of this substance with your skin may result in dermatitis. Other factors may or may not be related to your condition. Your physician will counsel you on appropriate management of your dermatitis.

Where Thimerosal Is Found:

Thimerosal is known widely as a first-aid product available as ?tincture of Merthiolate®? for home use. It is used as a preservative in cosmetics, including makeup removers, eye moisturizers, and mascaras. It may be found in soap-free cleansers; in nose, eye, and ear drops; and in eye ointments, topical medications, and antiseptic sprays. Exposure may occur through the use of cleaning fluids for contact lenses. Thimerosal also is used widely as a preservative in vaccines, antitoxins, tuberculin tests, and desensitization solutions.

How to Avoid Thimerosal:

Because thimerosal is found commonly in cosmetics; eye, ear, and nose preparations; and topical medications, it is important to use only ingredient-labeled products that do not list thimerosal or any of its synonyms on the label.

Inform your healthcare providers that you are allergic to thimerosal and ask for preparations that do not contain thimerosal or any other allergens to which you are likely to react.

Most live-virus vaccines, including influenza vaccine, do not contain thimerosal. However, many heat-killed or recombinant vaccines do. In general, patients with thimerosal allergy will not react to thimerosal when the vaccine is given in the muscle. In some patients, however, thimerosal-containing vaccines can cause dermatitis. Since this reaction is not life threatening, discuss with your physician the risks versus benefits of being vaccinated with thimerosal-containing vaccines for which there are no alternatives.

Note: These are general guidelines for avoiding this particular allergen in your daily activities. Please consult your physician regarding specific additional instructions for you.

Synonyms/Components of Thimerosal:

Mercurochrome®
Merthiolate®
Sodium ethylmercurithiosalicylate
Mercurothiolate
Merzonin
Mertorgan
Merfamin
Ethyl (2-mercaptobenzoato-S) mercury sodium salt
Thiomersalate
Thiomersal
Thiomersalan
[(o-carboxyphenyl)thio] Ethylmercury sodium salt

Other Substances to Which You May React:

Other organic mercury compounds (metallic mercury, as in dental fillings, is not an organic mercury compound)
Piroxicam Feldene®

How to Read Product Labels:

Now that you know the substances to which you are allergic, make a list, perhaps on a small card, of the names of all the chemicals to which you are allergic, along with all the synonyms for those chemicals, to take with you when shopping.

Before purchasing a product that may come in contact with your skin, look for its list of ingredients. The list of ingredients may be anywhere on the package. Read the list carefully to see if any of the names or synonyms are on the list. If so, ask your pharmacist or physician for a suitable alternative. Then check that product against your list.

When a product is not packaged, does not have a list of ingredients, or lists only the active ingredients, you have several choices: (1) find an alternative that does list all ingredients, (2) contact the manufacturer for a full list of ingredients, or (3) ask your pharmacist or physician for a suitable alternative.

Examples of Products:

This brief list is intended to provide a few examples; it is not intended as a comprehensive listing of all products in these categories. This information is subject to change without notice. Products are frequently reformulated by their manufacturers. Even with products you may have used with confidence in the past, read product labels carefully before use to be assured that they do not include this allergen.

Examples of Products Containing Thimerosal

Antibiotics for the Eye
Cortisporin® Ophthalmic Suspension
Neosporin® Ophthalmic Solution

Nasal Preparations
Nasal Moist® AF
Neo-Synephrine® Pediatric Formula, Mild Formula, Regular Strength, and Extra Strength Nasal Spray

Ear Preparations
Coly-mycin® S Otic
Cortisporin® Otic Suspension
Pediotic® Suspension

Cosmetics
L'Oreal® Miracle Wear Mascara
Stagelight® Mascara

Vaccines
Hep-B-Gammagee®
Recombivax HB®
Hyper-Tet®
Tetanus and diphtheria toxoids

Examples of Products Free of Thimerosal

Eye Preparations
Bausch & Lomb® Dry Eye Therapy
Murine® Lubricating Eyedrops
Hypotears® PF
Tobrex® and Tobradex® Solution or Ointment
Ocuflox® Solution
Timoptic® S
Iopidine®
Polysporin® Ophthalmic Ointment

Contact Lens Products
Renu® Enzymatic Cleaner
Opti-One® Rewetting Drops
Bausch & Lomb® Sensitive Eyes Sterile Saline Spray

Nasal Preparations
Afrin® Nasal Spray and Drops
NTZ® Nasal Spray and Drops
Beconase AQ®

Ear Preparations
Cortisporin® Otic Solution

Cosmetics
All Almay® products
All Physicians Formula® products

Vaccines
Most live-virus vaccines including influenza vaccine

Adverse reactions associated with patch testing include, burning, pruritus, erythema, and hyperpigmentation.

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