Table of Contents

Contrast Reactions

Pre-Medication Guidelines

Prednisone Based
50 mg prednisone by mouth at 13 hours, 7 hours, and 1 hour before contrast medium administration, plus 50 mg diphenhydramine intravenously, intramuscularly, or by mouth 1 hour before contrast medium administration.
Methylprednisolone Based
32 mg methylprednisolone by mouth 12 hours and 2 hours before contrast medium administration ± 50 mg diphenhydramine.
Both regimens are considered similarly effective. The presence of diphenhydramine in regimen 1 and not in regimen 2 is historical and not evidence-based. Therefore, diphenhydramine may be considered optional.

Source: ACR Contrast Manual (2021)

Iodinated Contrast and Renal Function

Gadolinium Based Contrast and Renal Function

Source: Weinreb JC, Rodby RA, Yee J, et al. Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2021;298(1):28-35. doi:10.1148/radiol.2020202903