Regimens for the prophylaxis of contrast reactions
Oral (to be used for outpatients)
- Prednisone 50 mg PO 13 hours, 7 hours, and 1 hour prior to contrast
- Benadryl* 50 mg PO 1 hour prior to contrast
*sedating; patient must have driver
Intravenous (to be used for ED and Inpatients)
- Methylprednisolone sodium succinate (e.g., Solu-Medrol®) 40 mg IV immediately, and then every 4 hours until contrast medium administration, plus diphenhydramine 50 mg IV 1 hour before contrast medium administration.
- or - - Hydrocortisone sodium succinate (e.g., Solu-Cortef®) 200 mg IV immediately, and then every 4 hours until contrast medium administration, plus diphenhydramine 50 mg IV 1 hour before contrast medium administration. This regimen usually is 4-5 hours in duration.
- And - - Benadryl 25-50 mg IV 1 hour prior to scan
Note: Premedication regimens less than 4-5 hours in duration (oral or IV) have not been shown to be effective.
Reference: ACR Manual on Contrast Version 10.3, 2018