From the Guidelines
Prednisone for iodine allergy prevention after cardiac catheterization should be discontinued immediately after the procedure, as there is no benefit to continuing it in patients with a history of allergic reactions to shellfish or seafood, according to the 2011 ACCF/AHA/SCAI guideline 1. The guideline states that the incidence of anaphylactoid reactions to contrast media is low, and there are no data to suggest that patients with seafood or shellfish allergies are at risk for an anaphylactoid reaction from exposure to contrast media 1. Some key points to consider when discontinuing prednisone include:
- The risk of adverse effects from steroid treatment, such as hyperglycemia in patients with diabetes, without any demonstrated benefit 1
- The lack of evidence supporting the use of steroid prophylaxis in patients with a history of allergic reactions to shellfish or seafood 1
- The importance of following the specific instructions of your doctor, as they may customize the treatment regimen based on your personal medical history and risk factors. It is essential to note that the use of prednisone for iodine allergy prevention is not supported by evidence, and its discontinuation after the procedure is recommended 1.
From the FDA Drug Label
Do not stop taking this medicine without first talking to your doctor. Avoid abrupt withdraw of therapy. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly
The decision to discontinue prednisone for iodine allergy after cardiac catheterization should be made by a doctor.
- Gradual withdrawal is recommended if prednisone is to be stopped after long-term therapy.
- Patients should not stop taking prednisone abruptly and should consult their doctor before discontinuing the medication 2.
From the Research
Discontinuation of Prednisone for Iodine Allergy after Cardiac Catheterization
- There is no direct evidence on when to discontinue prednisone for iodine allergy after cardiac catheterization.
- However, studies suggest that premedication with prednisone and antihistamines can be effective in preventing allergic reactions to iodinated contrast media 3.
- The duration of premedication is typically 13,7, and 1 hour before the procedure, with no significant difference in efficacy between lower (20 mg) and higher (50 mg) doses of prednisone 3.
- In cases of severe iodine contrast allergy, alternative contrast agents such as gadolinium may be used, but this is not directly related to the discontinuation of prednisone 4.
- Emergency pretreatment with intravenous steroids and H1 and H2 blockers has been used successfully in patients with previous contrast reactions undergoing emergency coronary angiography 5.
- The study on latex versus iodinated contrast media anaphylaxis in the cardiac cath lab does not provide information on the discontinuation of prednisone 6.
- Another study on iodinated contrast media allergy in patients hospitalized for investigation of chest pain does not provide guidance on when to discontinue prednisone 7.