Premedication prophylaxis for patients with previous acute allergic-like reaction to iodinated contrast

Nonurgent oral premedication:

Glucocorticoid-preferred regimen:

Adult: Oral prednisone 50 mg at 13, 7, and 1 hour prior to contrast administration.

Pediatric: Oral prednisone 0.5 to 0.7 mg/kg (maximum 50 mg per dose) at 13, 7, and 1 hour prior to contrast administration.

Glucocorticoid-alternate:

Adult: Oral methylprednisolone 32 mg at 12 and 2 hours prior to contrast administration.

Pediatric: Oral methylprednisolone 1 mg/kg (maximum 32 mg per dose) at 12 and 2 hours prior to contrast administration.

AND

H1 antihistamine:*

Adult: Diphenhydramine 50 mg oral, IM, or IV 1 hour prior to contrast administration.

Pediatric: Diphenhydramine 1.25 mg/kg oral, IM, or IV (maximum 50 mg) 1 hour prior to contrast administration.

Urgent intravenous premedication (eg, inpatients, emergency department):^¶

Hydrocortisone 200 mg IV 5 hours and 1 hour prior to contrast administration and diphenhydramine 50 mg IV 1 hour prior to contrast administration.*

Methylprednisolone 40 mg IV 5 hours and 1 hour prior to contrast medium administration and diphenhydramine 50 mg IV 1 hour prior to contrast administration.*

IV: intravenously; IM: intramuscularly.
* Although an antihistamine (eg, diphenhydramine) is commonly included, use has not been specifically studied and can be considered optional.
¶ Premedication regimens less than four to five hours in duration (oral or IV) have not been shown to be effective.

Data from: ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media, American College Radiology 2021 Available at: https://www.acr.org/Clinical-Resources/Contrast-Manual (Accessed on February 15, 2021).

Graphic 59096 Version 16.0

خرید پکیج

Premedication prophylaxis for patients with previous acute allergic-like reaction to iodinated contrast