EZ Cat Dry

Last updated on RxList: 1/9/2019
Drug Description

E-Z-CAT® DRY
(barium sulfate) Powder, for Suspension

DESCRIPTION

E-Z-CAT® DRY Barium Sulfate For Suspension (2% w/w After Mixing) is for oral administration. Each 100 g contains 41 g barium sulfate. Barium sulfate, due to its high molecular density, is opaque to x-rays and, therefore, acts as a positive contrast agent for radiographic studies. The active ingredient is barium sulfate and its structural formula is BaSO . Barium sulfate occurs as a fine, white, odorless, tasteless, bulky powder which is free from grittiness. Its aqueous suspensions are neutral to litmus. It is practically insoluble in water, solutions of acids and alkalies, and organic solvents.

Inactive Ingredients

artificial candied sugar, citric acid, ethyl vanillin, natural and artificial orange flavor, polysorbate 80, saccharin sodium, simethicone, sodium carboxymethylcellulose, sodium carrageenan, sodium citrate, sorbitol and xanthan gum.

Indications & Dosage

INDICATIONS

For use in Computed Tomography of the GI tract.

DOSAGE AND ADMINISTRATION

This product should be used as directed by a physician. The volume and concentration of the CT barium sulfate suspension to be administered will depend on the degree and extent of concentration required in the area(s) under examination and on the equipment and technique employed.

Instructions For Mixing

Add 450 mL water into a mixing container. Pour contents of the pouch into the container. Replace the cap, invert the container to mix the powder with water and shake vigorously for 20 seconds. Let mixture stand for 5 minutes. Reshake prior to use for 15 seconds.

Yield

460 mL of a 2% w/w barium sulfate suspension.

Suggested 30 Minute Barium Administration Protocol For Abdomen Studies

Administer 300 mL (10 fl oz) CT barium sulfate suspension 30 minutes before scan and 150 mL (5 fl oz) immediately prior to scan; or use as directed by physician.

Suggested 90 Minute Barium Administration Protocol For Abdomen/Pelvis Studies

Administer 450 mL (15 fl oz) CT barium sulfate suspension 90 minutes before scan, another 300 mL (10 fl oz) 30 minutes before scan, and 150 mL (5 fl oz) immediately prior to scan; or use as directed by physician.

HOW SUPPLIED

E-Z-CAT® DRY is supplied in the following quantities:

50 x 23 g (0.8 oz) Pouches, Cat. No. 727, NDC 32909-727-01

Storage

Store product at USP Controlled Room Temperature, 20 to 25°C (68 to 77°F).

After Reconstitution With Water, Product Must Be Refrigerated And Used Within 48 Hours. Discard Any Unused Portion.

Manufactured by: E-Z-EM Canada Inc. Revised: Aug 2018

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Side Effects & Drug Interactions

SIDE EFFECTS

Adverse reactions, such as nausea, vomiting, diarrhea and abdominal cramping, accompanying the use of barium sulfate formulations are infrequent and usually mild. Severe reactions (approximately 1 in 1,000,000) and fatalities (approximately 1 in 10,000,000) have occurred. Procedural complications are rare, but may include aspiration pneumonitis, barium sulfate impaction, granuloma formation, intravasation, embolization and peritonitis following intestinal perforation, vasovagal and syncopal episodes, and fatalities. It is of the utmost importance to be completely prepared to treat any such occurrence.

Allergic Reactions

Due to the increased likelihood of allergic reactions in atopic patients, it is important that a complete history of known and suspected allergies as well as allergic-like symptoms, e.g., rhinitis, bronchial asthma, eczema and urticaria, must be obtained prior to any medical procedure utilizing these products.

A mild allergic reaction would most likely include generalized pruritus, erythema or urticaria (approximately 1 in 250,000). Such reactions will generally respond to an antihistamine such as 50 mg of diphenhydramine or its equivalent. In the rarer, more serious reactions (approximately 1 in 1,000,000) laryngeal edema, bronchospasm or hypotension could develop. Severe reactions which may require emergency measures are often characterized by peripheral vasodilation, hypotension, reflex tachycardia, dyspnea, agitation, confusion and cyanosis progressing to unconsciousness. Treatment should be initiated immediately with 0.3 to 0.5 mL of 1:1000 epinephrine subcutaneously. If bronchospasm predominates, 0.25 to 0.50 grams of intravenous aminophylline should be given slowly. Appropriate vasopressors might be required. Adrenocorticosteroids, even if given intravenously, exert no significant effect on the acute allergic reactions for a few hours. The administration of these agents should not be regarded as emergency measures for the treatment of allergic reactions.

Apprehensive patients may develop weakness, pallor, tinnitus, diaphoresis and bradycardia following the administration of any diagnostic agent. Such reactions are usually non-allergic in nature and are best treated by having the patient lie flat for an additional 10 to 30 minutes under observation.

DRUG INTERACTIONS

The presence of barium sulfate formulations in the GI tract may alter the absorption of therapeutic agents taken concomitantly. In order to minimize any potential change in absorption, the separate administration of barium sulfate from that of other agents should be considered.

Warnings & Precautions

WARNINGS

Rarely, severe allergic reactions of an anaphylactoid nature have been reported following administration of barium sulfate contrast agents. Appropriately trained personnel and facilities should be available for emergency treatment of severe reactions and should remain available for at least 30 to 60 minutes following administration, since delayed reactions can occur.

PRECAUTIONS

General

Diagnostic procedures which involve the use of radiopaque contrast agents should be carried out under the direction of personnel with the requisite training and with a thorough knowledge of the particular procedure to be performed. A history of bronchial asthma, atopy, as evidenced by hay fever and eczema, or a previous reaction to a contrast agent, warrant special attention. Caution should be exercised with the use of radiopaque media in severely debilitated patients and in those with marked hypertension or advanced cardiac disease.

Diagnostic procedures which involve the use of radiopaque contrast agents should be carried out under the direction of personnel with the requisite training and with a thorough knowledge of the particular procedure to be performed. A history of bronchial asthma, atopy, as evidenced by hay fever and eczema, or a previous reaction to a contrast agent, warrant special attention. Caution should be exercised with the use of radiopaque media in severely debilitated patients and in those with marked hypertension or advanced cardiac disease.

Ingestion of this product is not recommended in patients with a history of food aspiration. If barium studies are required in these patients or in patients in whom integrity of the swallowing mechanism is impaired or unknown, proceed with caution. If this product is aspirated into the larynx, further administration should be immediately discontinued.

Usage In Pregnancy

Radiation is known to cause harm to the unborn fetus exposed in utero. Therefore, radiographic procedures should only be used when, in the judgement of the physician, its use is deemed essential to the welfare of the pregnant patient.

Nursing Mothers

Barium sulfate products may be used during lactation.

Overdosage & Contraindications

OVERDOSE

Apprehensive patients may develop weakness, pallor, tinnitus, diaphoresis and bradycardia following the administration of any diagnostic agent. Such reactions are usually non-allergic in nature and are best treated by having the patient lie flat for an additional 10 to 30 minutes under observation.

CONTRAINDICATIONS

This product should not be used in patients with known gastric or intestinal perforation or hypersensitivity to barium sulfate products.

Clinical Pharmacology

CLINICAL PHARMACOLOGY

Barium sulfate, due to its high molecular density, is opaque to x-rays and, therefore, acts as a positive contrast agent for radiographic studies. Barium sulfate is biologically inert and, therefore, is not absorbed or metabolized by the body, and is eliminated unchanged from the body.

Medication Guide

PATIENT INFORMATION

Before administration of this product patients should be instructed to:

  1. Inform their physician if they are pregnant.
  2. Inform their physician if they are allergic to any drugs or food, or if they have had any prior reactions to barium sulfate or other contrast agents used in x-ray procedures (see PRECAUTIONS - General).
  3. Inform their physician about any other medications they are currently taking.
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