WARNINGS: Rarely, severe and occasionally
fatal allergic reactions have been reported
TAGITOL V following administration of barium sulfate
contrast agents. Such a reaction can occur up
BARIUM SULFATE SUSPENSION
to 60 minutes following administration. (40% w/v, 30% w/w)
Allergic reactions are more likely to occur inindividuals with a history of allergic reactionsto barium sulfate products. PRECAUTIONS: General: Diagnostic proce- dures 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 DESCRIPTION: TAGITOL V is a barium sulfate
or advanced cardiac disease. Ingestion of
barium is not recommended in patients with a
administration. Each 100 mL contains 40 g
history of food aspiration. If barium studies are
barium sulfate. Barium sulfate, due to its high
required in these patients or in patients in
molecular density is opaque to x-rays and
whom integrity of the swallowing mechanism
therefore, acts as a positive contrast agent for
is unknown, proceed with caution. If barium is
radiographic studies. The active ingredient is
aspirated into the larynx, further administration
barium sulfate and its structural formula is
should be immediately discontinued, and a
white, odorless, tasteless, bulky powderwhich is free from grittiness. Its aqueous
Information for Patients: Before administration
suspensions are neutral to litmus. It is practi-
of this product, patients receiving barium
cally insoluble in water, solutions of acids
sulfate diagnostic agents should be instructed to:
1. Inform their physician if they are pregnant. Inactive Ingredients: artificial and natural
2. Inform their physician if they are allergic to
apple flavor, carboxymethylcellulose sodium,
any drugs or food, or if they have had any
citric acid, glycerin, maltodextrin, natural gum,
prior reactions to barium sulfate products or
polysorbate 80, potassium sorbate, purified
other contrast agents used in x-ray proce-
water, saccharin sodium, simethicone emulsion,
dures (see PRECAUTIONS-General).
sodium benzoate, sodium citrate and xylitol.
3. Inform their physician about any other
medications they are currently taking. CLINICAL PHARMACOLOGY: Barium sulfate,
4. Seek immediate medical attention if they
due to its high molecular density is opaque to
experience an allergic reaction after using
x-rays and, therefore, acts as a positive contrast
agent for radiographic studies. Barium sulfateis biologically inert and, therefore, is not
Drug Interactions: The presence of barium
absorbed or metabolized by the body, and is
sulfate formulations in the GI tract may alter
eliminated from the GI tract unchanged.
the absorption of therapeutic agents takenconcomitantly. In order to minimize any potential
INDICATIONS AND USAGE: For use in
change in absorption, the separate administra-
opacifying residual stool in the colon in CT
tion of barium sulfate from that of other agents
CONTRAINDICATIONS: This product should not Usage in Pregnancy:
pected gastric and intestinal perforation, or
hypersensitivity to barium sulfate or any
component of this barium sulfate formulation. PRECAUTIONS Continued
Apprehensive patients may develop weakness,pallor, tinnitus, diaphoresis and bradycardia
Therefore, radiographic procedures should
following the administration of any diagnostic
only be used when, in the judgement of the
agent. Such reactions are usually non-allergic
physician, its use is deemed essential to the
in nature and are best treated by having the
patient lie flat for an additional 10 to 30minutes under observation. Nursing Mothers: Barium sulfate products may be used during lactation.
All E-Z-EM barium sulfate contrast and bariumcontrast delivery systems are latex-free. ADVERSE REACTIONS: Adverse reactions, such as nausea, vomiting, diarrhea and abdominal cramping, accompanying the use OVERDOSAGE: On rare occasions following
of barium sulfate formulations are infrequent
and usually mild. Severe reactions (approxi-
cramps, nausea, vomiting, diarrhea or consti-
pation may occur. These indicated responses
can be present in both fluoroscopic and CT
occurred. Procedural complications are rare,
procedures. These are transitory in nature and
are not considered serious. Symptoms may be
intravasation, embolization and peritonitis
following intestinal perforation, vasovagaland syncopal episodes, and fatalities. DOSAGE AND ADMINISTRATION: For Oral Administration 24-hours prior to the procedure: ALLERGIC REACTIONS: Due to the increased
likelihood of allergic reactions in atopic
patients, it is important that a complete history
(noon) and dinner. Patient should be instructed
of known and suspected allergies as well as
that if a dose is missed they should take it
allergic-like symptoms, e.g., rhinitis, bronchial
asthma, eczema and urticaria, must beobtained prior to any medical procedure utilizing
STORAGE: Store product to protect from
these products. A mild allergic reaction would
freezing and excessive heat (above 40°C).
most likely include generalized pruritus,erythema or urticaria (approximately 1 in
SHAKE WELL PRIOR TO USE
250,000). Such reactions will generallyrespond to an antihistamine such as 50 mg of
HOW SUPPLIED: TAGITOL™ V is supplied in a
diphenhydramine or its equivalent. In the rarer,
carton containing 3 individual bottles, each
more serious reactions (approximately 1 in
1,000,000) laryngeal edema, bronchospasm or
hypotension could develop. Severe reactionswhich may require emergency measures areoften characterized by peripheral vasodilation,
Only (USA)
hypotension, reflex tachycardia, dyspnea,agitation, confusion and cyanosis, progressingto unconsciousness. All of the allergic symp-toms mentioned above can occur as either animmediate or delayed (up to 24 hours) reactions. Treatment should be initiated immediately with0.3 to 0.5 cc of 1:1000 epinephrine subcuta-neously. If bronchospasm predominates, 0.25to 0.50 grams of intravenous aminophyllineshould be given slowly. Appropriate vasopres-sors 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.
Suri Karthikeyan, M.D. Gastroentorology & Hepatology Suri Karthikeyan, M.D., M.R.C.P., F.R.C.P. (c) INSTRUCTIONS FOR COLONOSCOPIC PREP WITH MIRALAX AND CLEAR LIQUIDS READ CAREFULLY–DO NOT EXCEED RECOMMENDED DOSAGE AS SERIOUS SIDE EFFECTS MAY OCCUR. Name: _____________________________ You have been scheduled for the above examination. Please report to: Lakeside Memori
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