CONTRAST ALLERGY

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      These regimens are only indicated in patients who have mild allergic reactions - erythema, itching, hives. Patients with a history of anaphylactic reactions to contrast material are NOT CANDIDATES for pre-medication regimens and SHOULD NEVER receive contrast material.

 PREMEDICATION REGIMENS ELECTIVE PREMEDICATION

1. Prednisone – 50 mg by mouth at 13 hours, 7 hours, and 1 hour before contrast media injection, plus Diphenhydramine (Benadryl®) – 50 mg intravenously, intramuscularly, or by mouth 1 hour before contrast medium.  

OR  

2. Methylprednisolone (Medrol®) – 32 mg by mouth 12 hours and 2 hours before contrast media injection plus Diphenhydramine (Benadryl®) – 50 mg intravenously, intramuscularly, or by mouth 1 hour before contrast medium. I

f the patient is unable to take oral medication, 200 mg of hydrocortisone intravenously may be substituted for oral prednisone.  

                               EMERGENCY PREMEDICATION 

                               [In Decreasing Order of Preference]  

1. Methylprednisolone sodium succinate (Solu-Medrol®) 40 mg or hydrocortisone sodium succinate (Solu-Cortef®) 200 mg intravenously every 4 hours until contrast study required plus diphenhydramine 50 mg IV 1 hour prior to contrast injection.  

2. Dexamethasone sodium sulfate (Decadron®) 7.5 mg or betamethasone 6.0 mg intravenously q4h until contrast study in patent with known allergy to methylprednisolone, aspirin, or non-steroidal anti-inflammatory drugs, especially if asthmatic. Also diphenhydramine 50 mg IV 1 hour prior to contrast injection.  

3. Omit steroids entirely and give diphenhydramine 50 mg IV.   

REFERENCE: ACR Manual on Contrast Media. Version 10.1 © 2015