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Optison

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Overview

What is Optison?

Optison (perflutren protein-type A microspheres) injectable suspension is an ultrasound contrast agent for intravenous injection. The vial contains a clear liquid lower layer, a white liquid upper layer, and a headspace filled with perflutren gas. After resuspension, the sterile suspension is homogeneous, opaque, and milky-white.

Perflutren is chemically characterized as 1,1,1,2,2,3,3,3-perflutren with a molecular weight of 188, an empirical formula of CF and it has the following structural formula:

Each mL of Optison contains 5.0-8.0×10 protein-type A microspheres, 10 mg albumin human, 0.22 ± 0.11 mg/mL perflutren; and the following excipients: 0.2 mg N-acetyltryptophan, and 0.12 mg caprylic acid in 0.9% aqueous sodium chloride. The headspace of the vial is filled with perflutren gas. The pH is adjusted to 6.4-7.4. The protein in the microsphere shell makes up approximately 5-7% (w/w) of the total protein in the suspension. The microsphere particle size parameters are listed in Table 2.



What does Optison look like?



What are the available doses of Optison?

Injectable suspension: 5.0-8.0×10 protein-type A microspheres, 10 mg albumin human, and 0.22 ± 0.11 mg, perflutren per mL in 3mL single-patient use vials ().

What should I talk to my health care provider before I take Optison?

How should I use Optison?

Optison is indicated for use in patients with suboptimal echocardiograms to opacify the left ventricle and to improve the delineation of the left ventricular endocardial borders.

Recommended dose of Optison is 0.5 mL injected into a peripheral vein

Maximum total dose should not exceed 5.0 mL in any 10 minute period

Maximum total dose should not exceed 8.7 mL in any one patient study

If contrast enhancement is inadequate after the dose of 0.5 mL, additional doses of increments of 0.5 mL up to 5.0 mL in a 10 minutes period may be injected intravenously up to a maximum total dose of 8.7 mL.


What interacts with Optison?

Sorry No Records found


What are the warnings of Optison?

Sorry No Records found


What are the precautions of Optison?

Sorry No Records found


What are the side effects of Optison?

Sorry No records found


What should I look out for while using Optison?

Do not administer Optison to patients with known or suspected hypersensitivity to perflutren, blood, blood products or albumin

Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration. Most serious reactions occur within 30 minutes of administration


What might happen if I take too much Optison?

Sorry No Records found


How should I store and handle Optison?

Store OPTISON refrigerated between 2°- 8°C (36°- 46°F).Caution: Do not freeze.Carbidopa and levodopa tablets USP, 10 mg/100 mg are available in the following form:Mottled-blue, round, scored tablets, debossed "93"-"292" on the scored side and plain on the other side, packaged in bottles of 100 (NDC 51862-077-01) and 500 (NDC 51862-077-05).Carbidopa and levodopa tablets USP, 10 mg/100 mg are available in the following form:Mottled-blue, round, scored tablets, debossed "93"-"292" on the scored side and plain on the other side, packaged in bottles of 100 (NDC 51862-077-01) and 500 (NDC 51862-077-05).


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Clinical Information

Chemical Structure

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Clinical Pharmacology

The Optison microspheres create an echogenic contrast effect in the blood. The acoustic impedance of the Optison microspheres is much lower than that of the blood. Therefore, impinging ultrasound waves are scattered and reflected at the microsphere-blood interface and ultimately may be visualized in the ultrasound image. At the frequencies used in adult echocardiography (2-5 MHz), the microspheres resonate which further increases the extent of ultrasound scattering and reflection.

Non-Clinical Toxicology
Do not administer Optison to patients with known or suspected hypersensitivity to perflutren, blood, blood products or albumin

Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration. Most serious reactions occur within 30 minutes of administration

Caution should be exercised when the following drugs are administered concomitantly with carbidopa and levodopa

Symptomatic postural hypotension occurred when carbidopa and levodopa was added to the treatment of a patient receiving antihypertensive drugs. Therefore, when therapy with carbidopa and levodopa is started, dosage adjustment of the antihypertensive drug may be required.

For patients receiving MAO inhibitors (Type A or B), see . Concomitant therapy with selegiline and carbidopa levodopa may be associated with severe orthostatic hypotension not attributable to carbidopa levodopa alone (see ).

There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and carbidopa and levodopa.

Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of levodopa. In addition, the beneficial effects of levodopa in Parkinson's disease have been reported to be reversed by phenytoin and papaverine. Patients taking these drugs with carbidopa and levodopa should be carefully observed for loss of therapeutic response.

Use of carbidopa and levodopa with dopamine-depleting agents (e.g., reserpine and tetrabenazine) or other drugs known to deplete monoamine stores is not recommended.

Carbidopa and levodopa and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with levodopa and carbidopa and consequently reduce the bioavailability of carbidopa and levodopa.

Although metoclopramide may increase the bioavailability of levodopa by increasing gastric emptying, metoclopramide may also adversely affect disease control by its dopamine receptor antagonistic properties.

Serious cardiopulmonary reactions including fatalities have occurred uncommonly during or shortly following perflutren-containing microsphere administration, typically within 30 minutes of administration. The risk for these reactions may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias).

The reported reactions to perflutren-containing microspheres include: fatal cardiac or respiratory arrest, shock, syncope, symptomatic arrhythmias (atrial fibrillation, tachycardia, bradycardia, supraventricular tachycardia, ventricular fibrillation, ventricular tachycardia), hypertension, hypotension, dyspnea, hypoxia, chest pain, respiratory distress, stridor, wheezing, loss of consciousness and convulsions .

Always have cardiopulmonary resuscitation personnel and equipment readily available prior to Optison administration and monitor all patients for acute reactions.

The following serious adverse reactions are described elsewhere in the labeling:

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

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Tips

Tips

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Interactions

Interactions

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