Trade Names:Definity- Injection, suspension, lipid-based 1.2 × 10 10 /mL (as perflutren lipid microspheres)
Trade Names:Optison- Injection, suspension, protein-based 0.22 ± 0.11 mg/mL
Provides contrast enhancement of the endocardial borders during echocardiography.Perflutren, protein-based
Creates an echogenic contrast effect in the blood.
Protein binding expected to be minimal.
96% eliminated through the lungs; elimination half-life is 1.3 min.
No data available.Hepatic Function Impairment
The pharmacokinetics of perflutren have not been studied in subjects with hepatic disease.Elderly
The pharmacokinetics of perflutren in elderly patients have not been studied.
To opacify the left ventricular chamber and to improve delineation of the left ventricular endocardial borders in patients with suboptimal echocardiograms.
Known or suspected right-to-left, bi-directional, or transient right-to-left cardiac shunts; known or suspected hypersensitivity to perflutren or any component; administration by intra-arterial injection; hypersensitivity to blood, blood products, or albumin (protein-based only).
IV bolus 10 mcL/kg of the activated product within 30 to 60 sec, followed by a 10 mL saline flush. May repeat 30 min after first injection, if needed (max, 2 bolus doses). IV infusion 1.3 mL of activated product added to 50 mL of preservative-free saline, initiated at a rate of 4 mL/min and titrated to achieve optimal image enhancement. Max, 10 mL/min (max, 1 single IV infusion).Perflutren, protein-basedAdults
IV 0.5 mL injected into a peripheral vein. Additional doses of 0.5 mL, up to 5 mL cumulatively in a 10-min period, up to a maximum total dose of 8.7 mL in any 1 patient study.
Store between 36° and 46°F. Do not freeze.
None well documented.
Chest pain (1%); atrial fibrillation, cardiac arrest, cardiac ischemia, hypotension, supraventricular and ventricular arrhythmias, tachycardia or fibrillation (postmarketing).
Headache (5%); warm sensation/flushing (4%); dizziness (3%); malaise/weakness/fatigue (1%); convulsions, loss of consciousness (postmarketing).
Altered taste (2%).
Nausea and/or vomiting (4%).
Erythema, injection-site discomfort (1%).
Dyspnea (1%); anaphylactoid reactions (eg, bronchospasm, loss of consciousness, pruritus, shock, upper airway swelling, urticaria), decreased oxygenation, respiratory arrest or distress (postmarketing).
Back/renal pain, chills/fever, flu-like symptoms (1%).
Serious cardiopulmonary reactions, including fatalities, have occurred during or following perflutren administration. Assess all patients for conditions that preclude perflutren use. Monitor vital signs, ECG, and cutaneous oxygen saturation during and for at least 30 min after administration of perflutren in patients with pulmonary hypertension or unstable cardiopulmonary conditions. Ensure that resuscitation equipment and trained personnel are readily available.
Monitor vital sign measurements, electrocardiography, and cutaneous oxygen saturation in patients with pulmonary hypertension or unstable cardiopulmonary conditions during and for 30 min following perflutren administration. Closely observe all patients during and following perflutren administration. Monitor all patients for signs and symptoms of anaphylactoid reactions.
Category B (lipid-based); Category C (protein-based).
Safety and efficacy not established.
Reports of acute anaphylactoid reactions (eg, bronchospasm, loss of consciousness, pruritus, shock, upper airway swelling, urticaria) have occurred in patients with no prior exposure to perflutren.
May occur in patient with right-to-left, bi-directional, or transient right-to-left cardiac shunts.
Has occurred in patients receiving doses of up to 10 mcL/kg.
End-systolic triggering with high ultrasound mechanical indices and ultrasound mechanical index values of more than 0.8 may lead to ventricular arrhythmias.
Perflutren, protein-based, contains albumin; theoretical risk of transmission of Creutzfeldt-Jakob disease and viral diseases.
Copyright © 2009 Wolters Kluwer Health.