Adult Dosing
Contrast agent for echocardiography
- IV bolus
- 10 mcL/kg IV bolus injection within 30-60 seconds, followed by 10 mL saline flush; may repeat (dose & flush) after 30 minutes if required to prolong contrast enhancement
- Max: 2 bolus doses
- IV infusion
- 1.3 mL diluted with 50 mL saline (preservative-free) IV; start at 4 mL/minute, titrate PRN to not more than 10 mL/minute
- Max: 1 infusion
Notes:- Administer the drug only after activating in the Vialmix apparatus for the full 45-second activation cycle. Do not reactivate the vial
- Use immediately after activation. Re-suspend the microspheres by hand agitation for 10 seconds if not used within 5 minutes of activation; use within 12 hrs of activation
- Avoid injecting air into the vial
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Serious cardiopulmonary reactions, including deaths, have been reported with the use of perflutren, particularly in patients with pulmonary hypertension or unstable cardiopulmonary conditions. Most serious reactions occur within 30 minutes of administration. Monitor ECG, vital signs, and oxygen saturation during and after administration in such patients [US Black Box Warning]
- Fatal cardiac or respiratory arrest, unconsciousness, syncope, seizures, symptomatic arrhythmias, hypotension, hypertension, chest pain, stridor, respiratory distress, wheezing, or cardiac ischemia have been reported following administration of perflutren
- Trained staff and necessary equipment for cardiopulmonary resuscitation must be readily available for management of cardiopulmonary reactions [US Black Box Warning]
- Serious, uncommon, anaphylactoid reactions such as shock, bronchospasm, upper airway swelling, throat tightness, angioedema, edema (mouth, palatal, pharyngeal, localized), facial hypoesthesia, rash, flushing, urticaria, erythema, and pruritus have been reported during post-marketing studies of perflutren. Monitor all patients for hypersensitivity reactions
- Perflutren is contraindicated in patients with right-to-left, bi-directional, or transient right-to-left cardiac shunts due to the risk of microvascular occlusion and ischemia
- Avoid injection of the product via intra-arterial route
- Therapy may cause microsphere cavitation or rupture leading to fatal ventricular arrhythmias due to high ultrasound mechanical index values (>0.8)
- QTc prolongations >30 milliseconds and cardiac rhythm changes have been reported in patients administered with perflutren
Cautions: Use cautiously in
- Congenital heart defect
- Recent exacerbation of heart or lung conditions
Supplemental Patient Information
- Instruct patients to inform their physicians if they have a congenital heart defect, recent exacerbation of heart or lung conditions, or if they have had prior reactions to perflutren
- Advise patients to promptly inform their physicians if they are pregnant or nursing an infant at the time of administration
Pregnancy Category:B
Breastfeeding: Safety unknown. As many drugs are excreted in human milk, manufacturer advises caution when administered to a nursing woman. Nursing mothers should be advised to pump and discard breast milk once after treatment, due to the rapid clearance of this drug.
