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Perflutren Dosage

Applies to the following strength(s): (protein-type A microspheres) ; (lipid microspheres)

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Echocardiography

DEFINITY(R):
-Administer by IV bolus or IV infusion immediately after activation in the VIALMIX(R) apparatus; if more than 5 minutes elapses before use, resuspend with 10 seconds of hand agitation

Bolus Dosing:
-Administer 10 microL/kg IV bolus; follow with a 10 mL saline flush
-If necessary, a second 10 microL/kg IV bolus (followed with a 10 mL saline flush) may be administered 30 minutes later to prolong contrast enhancement
Maximum dose: 2 bolus doses

Infusion Dosing:
-Prepare an IV infusion by adding 1.3 mL activated Definity(R) suspension to 50 mL of preservative-free saline
-Begin IV infusion at 4 mL/minute; may titrate up to 10 mL/minute to achieve optimal image enhancement
Maximum Infusion Rate: 10 mL/minute
Maximum Dose: One IV infusion

Comments: The safety of bolus and infusion dosing in combination or in sequence has not been studied.

OPTISON(TM):
-Dose should be individualized taking into account body habitus, intervening lung tissue, adequacy of transducer skin interface, and other acoustic factors.
-Time from resuspension to injection should not exceed 1 minute, if time is exceeded, resuspend the microspheres.

-Initial dose: 0.5 mL IV into peripheral vein at a rate not to exceed 1 mL per second; follow with a flush of NS or D5W
-Additional doses in increments of 0.5 mL up to a cumulative dose of 5 mL in a 10 minute period may be administered if contrast enhancement is inadequate
-Maximum dose per study: 8.7 mL

Use: As an ultrasound contrast agent to opacify the left ventricular chamber and improve the delineation of the left ventricular endocardial borders in patients with suboptimal echocardiograms.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNING:
-SERIOUS CARDIOPULMONARY REACTIONS: Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration. Most serious reactions occur within 30 minutes of administration.
-Assess all patients for the presence of any condition that precludes administration
-Always have resuscitation equipment and trained personnel readily available

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Administer by IV bolus or IV infusion; do not administer by intra-arterial injection
-Imaging should begin immediately following drug administration
-Mechanical index should be set at 0.8 or below.

Optison(TM) Injection procedure:
-IV access in a peripheral vein should be provided with a 20-gauge or larger angiocatheter; suggested methods include a short extension tubing, heparin lock or IV line, all with a 3-way stopcock.
-For short extension tubing or heparin lock, fill 1 syringe with NS and flush the line for patency before and after injection.
-For a continuous IV line, open an IV line with NS (or D5W) at a slow infusion rate to maintain vascular patency; flush line immediately after injection of this drug.
-Do not aspirate blood back into syringe before administration as this may promote formation of a blood clot within the syringe.

Definity(R)
-Vial should warmed to room temperature prior to starting the activation process; activate vial by shaking the vial for 45 seconds using a VIALMIX(R) apparatus.
-After activation, product should appear as a milky white suspension; use immediately
-If more than 5 minutes elapses before use, resuspend with 10 seconds of hand agitation (inverting the vial).
-Invert vial and withdraw from the middle of the suspension using the needleless spike (Intellipin(TM) dispensing pin) or an 18 to 20 gauge syringe needle; do not inject air into the vial.
-Use immediately, do not allow product to stand in the syringe.
-Following IV bolus injection, flush with 10 mL of NS.

Optison(TM)
-Invert vial and gently rotate to resuspend the microspheres, this process will allow the product to come to room temperature.
-Inspect vial for complete resuspension, the vial should appear opaque milky-white; failure to adequately resuspend may result in inadequate contrast.
-Vent vial before withdrawing suspension; do not inject air into the vial.
-The time from resuspension to injection should not exceed 1 minute, if that time is exceeded, resuspend the microspheres in the syringe by gently rotating and inverting the syringe.
-IV access in a peripheral vein should be provided with a 20-gauge or larger angiocatheter; suggested methods include a short extension tubing, heparin lock or IV line, all with a 3-way stopcock.

Storage requirements:
-Prior to activation: Store refrigerated between 2C and 8C (36F to 46F)
-Single use only; Products do not contain preservatives and are intended for use in 1 patient on 1 occasion only.

Definity(R):
-Store activated product at room temperature in the original vial; the VIALMIX(R) activated vial may be used for up to 12 hours, but only after resuspending if more than 5 minutes elapses between resuspension and use; see VIALMIX Users Guide for specific instructions.

General:
-Diagnostic procedures that involved the use of contrast should be carried out under the direction of a physician with a thorough knowledge of the procedure to be performed.
-Baseline non-contrast echocardiography should be done prior to imaging with this product.

Monitoring:
-Patients should be monitored closely for at least 30 minutes after administration; resuscitation equipment and trained personnel should be readily available.

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