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Drugs reference index «Perflutren»


Pronunciation: (per-FLOO-tren)Class: Radiopaque agent

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


Perflutren, lipid-based

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.


Not metabolized.


96% eliminated through the lungs; elimination half-life is 1.3 min.

Special Populations

Renal Function Impairment

No data available.

Hepatic Function Impairment

The pharmacokinetics of perflutren have not been studied in subjects with hepatic disease.


The pharmacokinetics of perflutren in elderly patients have not been studied.

Indications and Usage

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).

Dosage and Administration

Perflutren, lipid-basedAdults

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.

General Advice

  • Vials are for single use only. Discard any unused portion.
  • Do not inject air into the vial when withdrawing a dose.
  • Perflutren, lipid-based
  • Administer only after activation in the Vialmix apparatus. Before injection, this product must be activated and prepared according to manufacturer's instructions.
  • Administer by IV bolus or infusion only.
  • If the product is not used within 5 min of Vialmix activation, resuspend the microspheres by 10 sec of hand agitation by inverting the vial. The activated perflutren may be used for up to 12 h after Vialmix , but only after the microspheres are resuspended by hand agitation.
  • Use the product immediately after withdrawing from the vial; do not allow to stand in the syringe.
  • After baseline noncontrast echocardiography, the mechanical index for the ultrasound device should be set at 0.8 or below. Inject activated perflutren and begin ultrasound imaging immediately.
  • Perflutren, protein-based
  • Administer in a peripheral vein only, at a rate of no more than 1 mL/second.
  • Follow injection with a flush of dextrose 5% or sodium chloride 0.9%.
  • Invert vial and gently rotate to resuspend microspheres.
  • Do not use if the solution appears clear rather than milky white after resuspension.
  • Vent vial with a sterile vent spike or a sterile 18-gauge needle before withdrawing product from the vial.
  • If more than 1 min has passed after withdrawing contents of the vial into a syringe, resuspend the microspheres by gently rotating and inverting the syringe.
  • Do not aspirate blood back into the syringe before administration; this may lead to formation of a blood clot within the syringe.


Store between 36° and 46°F. Do not freeze.

Drug Interactions

None well documented.

Adverse Reactions


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%).



Cardiopulmonary reactions

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.

QTc prolongation

Has occurred in patients receiving doses of up to 10 mcL/kg.

Ventricular arrhythmias

End-systolic triggering with high ultrasound mechanical indices and ultrasound mechanical index values of more than 0.8 may lead to ventricular arrhythmias.

Viral disease

Perflutren, protein-based, contains albumin; theoretical risk of transmission of Creutzfeldt-Jakob disease and viral diseases.

Patient Information

  • Advise patients to inform health care provider if they may be pregnant or are breast-feeding an infant.
  • Instruct patients to inform health care provider if they have ever had an allergic or hypersensitivity reaction to blood, blood products, or albumin (protein-based).
  • Advise patients to inform health care provider if they have a congenital heart defect, or recent worsening of heart or lung conditions.

Copyright © 2009 Wolters Kluwer Health.

  • Definity Prescribing Information (FDA)
  • Definity MedFacts Consumer Leaflet (Wolters Kluwer)
  • Definity Advanced Consumer (Micromedex) - Includes Dosage Information
  • Optison Prescribing Information (FDA)
  • Optison MedFacts Consumer Leaflet (Wolters Kluwer)
  • Optison Advanced Consumer (Micromedex) - Includes Dosage Information

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