University of Wisconsin Hospital and Clinics Guidelines For Optional Premedication Of Individuals With History Of Latex Sensitivity, Elevated IGE, Or Positive Latex Allergy Testing


Please address questions, comments, and suggestions regarding this guideline to Lee Vermeulen, Director, Center for Drug Policy and Clinical Economics at 608/262-7537.

Reviewed by: OR Committee, Resuscitation Committee, Patient Care and Procedure Committee

Last Revised: January 1997
Re-Approved by P&T Committee: July 2000
Scheduled for Reconsideration: July 2003
Guidelines
References

Guidelines

The following doses are recommendations and should be adjusted within accordance to a patient's individual status and disease state. Premedication cannot be used as an alternative to antigen avoidance, but may reduce the severity of an antigen-induced reaction.

  1. Oral regimen - begin the night before scheduled surgery, and continue for 12-18 hours postoperatively:
    Ranitidine/Nizatidine
    Ped: 1.25-2 mg/kg/dose po q 12 hours (up to a max of 150 mg q 12 hours)
    Adult: 150 mg po q 12 hours
    plus Prednisone/Prednisolone
    Ped: 0.5 mg/kg/dose po q 6 hours (up to a max of 60 mg per day)
    Adult: 20 mg po tid
    plus Diphenhydramine
    Ped: 1 mg/kg/dose po q 6 hours (up to a max of 200 mg/24 hours)
    Adult: 50 mg po q 6 hours

  2. IV regimen - can attain therapeutic levels quickly; useful if the risk for latex sensitivity is not identified until soon before surgery. Begin as soon as possible prior to surgery and continue for 12 to 18 hours postoperatively.
    Ranitidine
    Ped: 0.1-0.8 mg/kg/dose IV q 6-8 hours (up to a max of 50 mg IV q 8 hours)
    Adult: 50 mg IV q 8 hours
    plus Methylprednisolone
    Ped: 1-2 mg/kg/dose IV q 6 hours
    Adult: 20 mg IV q 6 hours
    plus Diphenhydramine
    Ped: 1 mg/kg/dose IV q 6 hours (up to a max of 200 mg per 24 hours)
    Adult: 50 mg IV q 6 hours

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References

  1. Benitz, WE, Tatro, DS. "The Pediatric Drug Handbook" 2nd ed. 1988. Yearbook Medical Publishers, Inc.
  2. Merguerian, PA, Klein, RB, Graven, MA, and Rozycki, AA. Intraoperative anaphlyactic reaction due to latex hypersensitivity. Urology 1991:39 (4):301-304.

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