Radiographic and magnetic resonances contrast agents: Essentials and tips for safe practices

Table 3 Common elective premedication protocols for high-risk patients to develop iodinated contrast medium hypersensitivity reactions

Elective		Emergency
Lasser protocol	Greenberger protocol1	IV protocols (in descending order of desirability)
Oral prednisone 50 mg at 13/7 and 1 h before contrast medium injection	Oral methylprednisolone 32 mg at 12 and 2 h before contrast medium injection +/-	Methylprednisolone sodium succinate 40 mg
		OR
		hydrocortisone sodium succinate 200 mg
		every 4 h till examination
		+ diphenhydramine 50 mg IV - 1 h
+ (oral/IM or IV) diphenhydramine 50 mg just 1 h before examination	+/- (oral/IM or IV) diphenhydramine 50 mg just 1 h before examination	No corticosteroids at all
		(not preferable)
		Only diphenhydramine 50 mg IV

¹IV hydrocortisone 200 mg may be a substitute for oral prednisone, if the patient cannot tolerate oral medication.