E-Z-HD
Clinical safety rating: caution
Comprehensive clinical and safety monograph for E-Z-HD (E-Z-HD).
E-Z-HD is a barium sulfate contrast agent that acts by coating the mucosal surface of the gastrointestinal tract, providing radiographic contrast due to its high atomic number, which attenuates X-rays.
| Metabolism | Barium sulfate is not metabolized; it is eliminated unchanged in the feces. |
| Excretion | Renal: 0%; Biliary/Fecal: 100% (eliminated unchanged in feces as insoluble barium sulfate) |
| Half-life | Not applicable (non-absorbed, local GI agent; negligible systemic absorption) |
| Protein binding | 0% (non-absorbed, no plasma binding) |
| Volume of Distribution | Not applicable (non-absorbed, remains in GI tract; no systemic Vd) |
| Bioavailability | Oral: 0% (insoluble, not absorbed; local effect only) |
| Onset of Action | Immediately upon oral administration (coats GI mucosa on contact) |
| Duration of Action | Transit time dependent (typically 30-60 minutes for upper GI; colon studies: 2-4 hours) |
Barium sulfate suspension, 60-120 mL (30-100% w/v) orally for single or double-contrast upper GI studies; for lower GI studies, 500-1500 mL (10-20% w/v) as enema.
| Dosage form | FOR SUSPENSION |
| Renal impairment | No dose adjustment required as barium is not absorbed systemically when used as contrast agent. |
| Liver impairment | No dose adjustment required as elimination does not rely on hepatic function. |
| Pediatric use | Upper GI: 5-10 mL/kg (max 60 mL) of 30-100% w/v suspension orally; lower GI: 10-15 mL/kg of 10-20% w/v suspension as enema, based on body weight. |
| Geriatric use | No specific dose adjustment; use lower end of dosing range due to potential swallowing difficulties or constipation risk. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for E-Z-HD (E-Z-HD).
| Breastfeeding | Barium sulfate is not absorbed systemically and does not pass into breast milk. Compatible with breastfeeding. M/P ratio not applicable due to lack of systemic absorption. |
| Teratogenic Risk | Barium sulfate, the active ingredient in E-Z-HD, is not absorbed systemically following oral administration. No teratogenic effects have been reported in animal studies or human data. Risk to fetus is considered negligible across all trimesters. |
| Fetal Monitoring |
■ FDA Black Box Warning
Warning: Serious hypersensitivity reactions, including anaphylaxis and death, have occurred. Intravenous administration is contraindicated; use only for oral or rectal administration.
| Serious Effects |
["Known or suspected gastrointestinal obstruction or perforation","History of severe hypersensitivity to barium sulfate or any excipient","Pyloric stenosis (relative)","Perforated gastrointestinal tract"]
| Precautions | ["Risk of aspiration, especially in patients with swallowing disorders or impaired gag reflex","Risk of intestinal obstruction or perforation in patients with known or suspected gastrointestinal obstruction or perforation","Hypersensitivity reactions, including anaphylaxis, may occur; emergency equipment should be available","Use with caution in patients with inflammatory bowel disease, intestinal strictures, or impaired motility"] |
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| No specific monitoring required beyond standard clinical observation during imaging procedure. Ensure adequate hydration to prevent constipation. |
| Fertility Effects | No known effects on fertility due to lack of systemic absorption. |