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 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.

CONTRAINDICATIONS:

• Hypersensitivity to this drug or any of the components such as polyethylene glycol (PEG)
• Hypersensitivity to blood, blood products or albumin (Optison TM)

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:

• Use the product immediately after vial withdrawal. Do not allow it to stand in the syringe.
• Inject via intravenous bolus or intravenous infusion. Do not administer by intra-arterial injection.
• Mechanical index should be set at 0.8 or below.
• The safety of bolus and infusion dosing in sequence or in combination has not been studied.

Storage requirements:

• Store between 2C to 8C (36 to 46F)
• Products do not contain preservatives and are intended for use in 1 patient on 1 occasion only.

Reconstitution/preparation techniques:

• Before injection, this drug must be activated and prepared according to the manufacturer's instructions.

Monitoring:

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

Patient advice:

• Inform you healthcare provider immediately if you develop any symptoms of hypersensitivity, including rash, wheezing, or shortness of breath.