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Prophylactic measures can decrease the incidence and severity of contrast reactions but do not entirely eliminate the risk of their occurrence. Pretreatment of patients with contrast allergy usually consists of corticosteroids and antihistamines. Mild reactions may be treated with a similar regimen; however, more severe reactions such as laryngeal edema, bronchospasm, and hypotension require the immediate ACLS treatment.

According to Topol and Teirstein (2012), depending on physician preference, there is a combination of H1 and H2 blockers that can be given with steroids for known IV contrast dye allergies:

• Prednisone 40 to 50 mg orally 13, 7, and 1 hours(s) prior to procedure
• Hydrocortisone 100 mg IV 1 hour prior to procedure
• Methylprednisolone 32 mg at 12 hours and 2 hours before the study
• Cimetidine 300 mg orally or Ranitidine IV or orally 1 hour prior
• Diphenhydramine 50 mg IV 1 hour prior
• Montelukast 10 mg orally 1 hour prior Nausea and vomiting, a metallic taste in the mouth, generalized warmth, or flushing are symptoms associated with contrast dye injections. These symptoms are usually mild and non-life-threatening and can be minimalized with slowing the infusion (Maddox, 2002).