Hydrocortisone Dose for Prophylaxis of Contrast Induced Reaction

Most of the references recommended to use: IV Hydrocortisone 200mg, 4 hours before the procedure.

Reference 1: Online Web <http://radiology.yale.edu/patientcare/policies/premedication.aspx>

In an emergency setting an alternative faster (but less proven) regime is:

• 200mg Hydrocortisone IV 4 hours before injection.
• 50mg Benadryl (Diphenhydramine) IV/PO within 1 hour of the injection. 

Reference 2: Guideline on Contrast Reaction Prophylaxis – Pre Medication Regimens

Emergent Pre-Medication:

• Hydrocortisone sodium succinate 200mg IV 4-6 hours before contrast injection, plus diphenhydramine 50mg IV 1 hour before contrast injection.

Reference 3: Guideline - ACR Manual on Contrast Media

Emergency Premedication:

• Hydrocortisone sodium succinate 200mg intravenously every 4 hours (q4h) until contrast study required plus diphenhydramine 50mg IV 1 hour prior to contrast injection.

References:

• Online Web <http://radiology.yale.edu/patientcare/policies/premedication.aspx>
• Guideline on Contrast Reaction Prophylaxis – Pre Medication Regimens
• Guideline - ACR Manual on Contrast Media