Two pretreatment regimens for high-risk patients receiving radiographic contrast media

Paul A. Greenberger*, Roy Patterson, Robert C. Radin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


The risk of anaphylactoid reaction (AR) developing from radiographic contrast media in patients who previously have had an AR to radiographic contrast media ranges from 17% to 60%. Pretreatment with prednisone plus diphenhydramine or prednisone and diphenhydramine plus ephedrine decreased the reaction rate to 9.0% and 3.1%, respectively, during 657 procedures in 563 patients. No deaths occurred, and only three episodes of transient hypotension developed, one of which was treated with epinephrine. Pretreatment consisted of prednisone, 50 mg, 13 hr, 7 hr, and 1 hr before the procedure and diphenhydramine, 50 mg, 1 hr and or ephedrine, 25 mg, 1 hr before the procedure. The addition of ephedrine provided a statistically significant reduction in reaction in 192 procedures (χ2 = 5.4996, p = 0.019). In 138 procedures in patients whose initial AR was considered serious, pretreatment was as effective as for patients with histories of mild to moderate reactions. Emergency equipment should be available for all procedures.

Original languageEnglish (US)
Pages (from-to)540-543
Number of pages4
JournalThe Journal of allergy and clinical immunology
Issue number4 PART 1
StatePublished - Oct 1984

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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