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MICROCAT is a brand name for Barium. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: This medicinal product is for diagnostic use only. Opacification of the gastrointestinal tract during computerised axial tomography.
Verbatim from this product's MHRA label. Tap a section to expand.
5 % w/v) swallowed at the beginning of the examination, or as the radiologist prefers. Elderly No special dosage regimen is required, but care should be taken to observe the contra- indications and warnings below. Paediatric population No children’s dose is recommended, as such investigations in children are rare and specialised.
The dosage will therefore be tailored by the radiologist to suit the special requirements in each case.
Adverse reactions are presented in the following table by system organ class and by frequency according to the following categories: very common (≥1/10), common (≥1/100 to 1<1/10), uncommon (≥1/1 000 to 1<1/100), rare (≥1/10 000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated on the basis of available data).
System Organ Class Frequency : adverse reaction Blood and lymphatic system disorders Unknown frequency: In case of intravasation: disseminated intravascular coagulation Immune system disorders Unknown frequency: Anaphylactic reaction, anaphylactoid reaction, hypersensitivity Gastrointestinal disorders Unknown frequency: Intestinal obstruction, vomiting, diarrhoea, abdominal pain, stercoroma, abdominal distension, constipation, nausea, flatulence In case of intestinal perforation: peritonitis Respiratory, thoracic and mediastinal disorders Unknown frequency: Pneumonia aspiration, pulmonary fibrosis Nervous system disorders Unknown frequency: Presyncope Skin and subcutaneous tissue disorders Unknown frequency: Urticaria, rash Sodium methyl parahydroxybenzoate can cause hypersensitivity immediate and also delayed reactions.
Very rarely - though even after initial use - hypersensitivity reactions of varying intensity can occur with barium sulfate contrast agents. Should this occur, treatment must be discontinued immediately. Such reactions call for immediate medical treatment.
In very rare cases administration of barium sulfate can result in the formation of so-called baroliths. In case of intestinal perforation, the passage of barium sulfate in the abdominal cavity can be the cause of abscesses, inflammations, peritonitis, granulomas and adhesions with possibly fatal outcome and the need for surgery.
In case of extra luminal passage of barium sulfate, exceptional cases of intravasation accompanied by a systemic diffusion of barium sulfate may occur, which can be potentially fatal. The intravasation of barium sulfate may be responsible for deep venous embolism, shock, respiratory distress and disseminated intravascular coagulation.
Not for injection. Special warnings Severe adverse reactions have been reported in combination with the administration of barium sulfate compositions, including aspiration, intravasation, perforation, anaphylaxis, with possible life-threatening or fatal outcome.
These reactions were usually related to the administration technique, the underlying pathological condition and/or patients hypersensitivity. The product should be taken under medical supervision. Rapid detection, assessment and diagnosis are essential for an effective implementation of treatment of potentially severe adverse reactions.
Imaging facilities should have trained and specialised personnel for the diagnosis and treatment of hypersensitivity reactions. Urgent specialised medical measures are required in the event of aspiration, intravasation or perforation (intensive care, surgery).
To prevent potentially severe adverse reactions, care must be taken to keep barium sulfate from entering parenteral regions such as tissues, intravascular space or body cavities as well as the airways. The indication must be very carefully considered in small children and elderly patients with multiple organ failure, especially in the cardiovascular system, as the examination and preparatory measures can be stressful.
Precautions for use Hypersensitivity Patients who have already experienced a reaction during previous administration of barium sulfate present an increased risk of experiencing another reaction on subsequent administration of this contrast agent, or possibly other barium sulfate contrast agents, and are therefore considered to be at high risk.
Hypersensitivity reactions can occur even after the first administration of the product, and are often unpredictable. Should this occur, treatment must be discontinued immediately. Such reactions call for immediate medical treatment.
The administration of barium sulfate may aggravate symptoms of an existing asthma. In patients with asthma unbalanced by the treatment, the decision to use barium sulfate must be made after careful evaluation of the benefit/risk ratio.
1; - Confirmed or suspected intestinal obstruction or perforation, including pyloric stenosis; - Suspected peritonitis or fistulas in the gastrointestinal tract; - Fresh wounds or erosions of the oesophagus or gastrointestinal tract, or gastrointestinal bleeding; - Ischaemia of the bowel wall; - Necrotising enterocolitis; - Postoperative suture failure.
Barium sulfate must not be administered immediately before or for up to seven days after gastrointestinal surgery, including endoscopic excision procedures, snare polypectomy or hot biopsy of the colon. The product must not be used if postoperative leaks are expected.
Do not use the product during or for up to four weeks after neck, chest (if oral use) or abdominal radiotherapy.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for the MHRA Yellow Card in the Google Play or Apple App Store.
Perforation Because of the increased risk of perforation, the benefit-to-risk ratio must be carefully assessed in patients with oesophageal atresia or with severe stenosis, especially distal to the stomach, as well as in patients with disorders and diseases involving a high risk of perforation such as intestinal carcinoma, inflammatory bowel diseases, diverticulosis, diverticulitis, and parasitic disease.
In the event of oesophageal atresia, opacification of the pouch should be avoided as far as possible. If performed, the smallest amount of contrast agent should be used and then withdrawn. Leakage of barium into the retroperitoneum or mediastinum may cause few immediate symptoms but delayed endotoxic shock can develop 12 hours later and is frequently fatal.
In case of intestinal perforation, the passage of barium sulfate in the abdominal cavity can be the cause of abscesses, inflammations, peritonitis, granulomas and adhesions with possibly fatal outcome and the need for surgery. Aspiration Care should be taken in patients with respiratory and swallowing disorders, including dysphagia and reduced alertness, due to the risk of aspiration.
In patients who are highly susceptible to aspiration (neonates, elderly and stroke patients), the procedure should begin with a small oral dose. - Vomiting after oral administration of barium sulfate can result in aspiration pneumonia.
Aspiration into the tracheobronchial system is possible during oral administration to infants of barium sulfate suspension in bottles and during administration of large quantities via a catheter. Cardiopulmonary arrest with fatal outcome can occur after aspiration by infants.
Aspiration of small quantities can result in airways inflammation and pneumonia. Barium should not be administered to patients with a history of foodstuff aspiration. In such patients in whom the barium procedure is absolutely necessary, it must be carried out with great care.
In the event of aspiration into the larynx, product administration must be discontinued immediately. Fluid overload Fluid overload due to water absorption from barium sulfate suspensions has been reported. Children and patients with impaired renal function as well as children with Hirschsprung's disease are the most susceptible to water intoxication.
Intravasation It is possible for barium sulfate to cross the intestinal wall and enter the venous drainage of the colon, allowing a barium embolism to reach the circulatory system. Intravasation occurs very rarely, but can result in fatal complications such as systemic and pulmonary embolism, disseminated intravascular coagulation, septicaemia and persistent severe hypotension.
The diagnosis should be considered in all patients who collapse during or after the barium procedure, and in patients who do not feel well in the first hours after the procedure. It can be confirmed by a plain X-ray examination. A CT scan may be useful in detecting dissemination of barium sulfate.
Barium impaction and barolith Care should be taken in patients with pre-existing constipation, disturbed stomach emptying, colon stenosis, diverticulosis and colon atony, due to the risk of barium stercoroma, particularly in elderly subjects.
Barium sulfate can be retained in colonic diverticula where it can maintain or intensify infections. Baroliths develop from inspissated barium in faeces. They are often asymptomatic but may cause abdominal pain, appendicitis, intestinal obstruction or intestinal perforation.
The risk of developing baroliths is higher in elderly patients with impaired intestinal motility, ileus, electrolyte imbalance, dehydration or with fiber-deficient diets. To prevent any damage to the intestinal wall, the baroliths should be removed.
Barium sulfate can cause or aggravate pre-existing constipation. To prevent severe constipation, barium impaction and barolith, a proper oral […]