9/23/2012
Are you aware of any protocols to premedicate patients who have a history of reactions to radiocontrast material that are more rapid than the routine night before and day of treatment with steroids and diphenhydramine? The radiologists at my institution want to know if pretreatment with steroids and H1 and H2 blockers done one to two hours before a dye study would be safe.

Thank you for your inquiry.

There are a number of published protocols for pretreatment of radiocontrast reactions including one which is used in an emergency that was developed by the Northwestern Group. All of these are discussed in detail in the Manual on Contrast Media, Version 7, 2010. This is the official manual of the American College of Radiology Committee on Drugs and Contrast Media. A PDF of this manual is available to you at no charge online.

Manual on Contrast Media – Version 7, 2010

If this link does not work, you can simply Google “Radiology Guidelines for Radiocontrast” and this document will appear in your search. There is a section entitled “Pretreatment Strategies” on Page 5. All of the strategies accepted by this committee of the American College of Radiology are noted here. Some of them take less time than the one that you mentioned in your inquiry.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.