GBCA moderate allergic-like reaction

Recognize

• Diffuse urticaria after gadolinium
• Facial edema without dyspnea
• Bronchospasm with mild or no hypoxia
• Throat tightness / hoarseness without dyspnea

Act — tap each step

1. 1Monitor vitals + pulse oximetry
2. 2Oxygen 6–10 L/min by mask
3. 3Albuterol MDI 2 puffs ×3 for bronchospasm
4. 4Diphenhydramine 25–50 mg IV/IM
5. 5If progression: IM epinephrine — see severe pathway

Medications

Notes

• Prior allergic-like reaction to GBCA is the strongest risk factor for recurrence.
• Having a prior reaction to iodinated contrast does NOT increase risk for GBCA reaction (and vice versa) beyond baseline allergy risk.