Premedication Protocols for Contrast Allergies

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Nov 21st, 14

Premedication Protocols for Contrast Allergies

If the patient has had any prior reaction to iodinated or gadolinium based contrast agents or a severe reaction to other allergens, they must be premedicated.

Elective Premedication (Adult)

Methylprednisolone (Medrol) 32 mg by mouth 12 hours and 2 hours before contrast media injection. *

Diphenhydramine (Benadryl) 50 mg PO, IM or IV one hour before contrast media (Patient will need a driver) **

 

*Note: It is required that the steroid dose by taken at least 6 and preferably 12 hours prior to the exam.

**Note: It is not critical to administer diphenhydramine as part of the premedication regimen (there are published regimens using only corticosteroids). While it is part of the radiology protocol, it is not mandatory.

 

 

Emergency Premedication (Adult)

Methylprednisolone (Solu-Medrol) - 125 mg IV one time dose 4-6 hours prior to exam*

Diphenhydramine (Benadryl) 50 mg IV one time dose one hour prior to exam

Famotidine (Pepcid) - 20 mg IV one time dose one hour prior to exam

*Note: IV steroids have not been shown to be effective when administered less than 4-6 hours prior to contrast injection.

 

Pediatric: children who weigh 40 kg or less.

Prednisone 0.5 mg/kg  PO (50 mg maximal dose) to be given 13 hours, 7 hours and 1 hour prior to exam

Diphenhydramine (Benadryl) 1.0 mg/kg (50 mg maximal dose) to be given 1 hour prior to exam.

 

 

In patients who have a prior documented reaction to contrast media, the use of a different contrast agent has been advocated and may be protective in addition to a premedication regimen.

 

 

Reference: ACR Manual on contrast Media version 9, 2013

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