Anaphylaxis — Premedication for Sensitized Patients — Clinical Pathway: Outpatient

Anaphylaxis Clinical Pathway — Outpatient Specialty Care and Primary Care

Premedication for Sensitized Children

In children with known sensitivity to radiographic contrast media, blood products, or immunotherapies, premedication should be considered. Premedication may lessen the clinical manifestations but not prevent reactions in high-risk children.

Premedication Regimen Begun the Day Prior to Procedure Medication

Medication Route Dose Maximum Dose Frequency
Corticosteroid
  • Prednisone/Prednisolone
 IV
PO		 1 mg/kg/dose
1 mg/kg/dose		 30 mg/dose
30 mg/dose		 Q 6 hrs for 3 doses prior to procedure, then 1 dose prior to start to procedure
H1 Blocker
  • Diphenhydramine
    or
  • Cetirizine (may be less sedating)
 IV/PO
PO		 1 mg/kg/dose
6-23 months:
2.5 mg/day

2-5 years:
2.5-5 mg/day

> 6 years:
5-10 mg/day		 50 mg/dose
10 mg		 Q 6 hrs until procedure is completed
Once

Premedication Regimen Begun on Day of Procedure

Medication Route Dose Maximum Dose Frequency
Corticosteroid
  • Methylprednisolone
 IV
IV		 2 mg/kg/dose
1 mg/kg/dose		 60 mg/dose
30 mg/dose		 Immediately prior to procedure Q 6 hrs until procedure is completed
H1 Blocker
  • Diphenhydramine
  •  
 IV/IM 1 mg/kg/dose 50 mg/dose 1 hr prior to procedure