perflutren: clinical use

Prescribing considerations

• Reserve for diagnostic echocardiography when the non-contrast study is inconclusive.
• Administration should be undertaken by clinicians experienced in diagnostic ultrasound, with immediate access to treatment and equipment for severe hypersensitivity.
• Clinical experience is limited in severely ill patients, including unstable cardiac disease, severe respiratory disease, sepsis, hypercoagulable states and end-stage hepatic or renal disease; assess carefully and monitor closely.
• Record the product name and batch number because the formulation contains human albumin.
• Safety and efficacy below 18 years have not been established.

Contraindications and cautions

• Hypersensitivity to perflutren or any excipient, including human albumin.
• Pulmonary hypertension with systolic pulmonary artery pressure above 90 mmHg.

Monitoring

• Use ECG monitoring during contrast echocardiography.
• Observe during and after administration for hypersensitivity, respiratory symptoms, chest pain and rhythm disturbance.
• Use a low ultrasound mechanical index and end-diastolic triggering as recommended in the product information.

Clinical pharmacology

Perflutren is an inert fluorocarbon gas enclosed in transpulmonary albumin microspheres. Their marked acoustic mismatch with soft tissue generates strong ultrasound echoes. The gas component is rapidly and almost completely eliminated through the lungs, with a pulmonary elimination half-life of under two minutes in healthy-volunteer studies.

Formulation and product differences

• The selected product is a dispersion of perflutren-filled, heat-treated human-albumin microspheres suspended in human albumin solution.
• It contains sodium and is supplied in single-use vials; the microspheres separate on standing and require careful resuspension before administration.
• It must not be frozen, mixed with other medicinal products or administered by an unapproved route.

Injection

Route: Parenteral

Strengths: 0.19 mg/mL