LUMASON

Clinical safety rating: caution

Comprehensive clinical and safety monograph for LUMASON (LUMASON).

How it works

LUMASON (sulfur hexafluoride lipid-type A microspheres) is an ultrasound contrast agent that consists of gas-filled microspheres. After intravenous injection, the microspheres enhance the ultrasound signal by increasing the backscatter of ultrasound waves, thereby improving the visualization of cardiac chambers, endocardial borders, and vascular structures.

What the body does with it

Metabolism	Sulfur hexafluoride is eliminated unchanged via the lungs. The lipid shell components are metabolized via normal lipid pathways.
Excretion	Primarily renal; >90% excreted unchanged in urine within 24 hours. Fecal elimination is negligible (<1%).
Half-life	Terminal elimination half-life is approximately 2 hours (range 1.5–2.5 hours) after intravenous administration, reflecting rapid clearance and supporting use as a diagnostic agent without significant accumulation.
Protein binding	Protein binding is negligible (<5%); predominantly bound to albumin if any, but essentially free in plasma.
Volume of Distribution	Volume of distribution is approximately 0.3 L/kg (range 0.2–0.4 L/kg), consistent with distribution primarily in the extracellular fluid and minimal tissue binding.
Bioavailability	Bioavailability is 100% via intravenous route, as it is administered as an IV injection. Oral bioavailability is not applicable.
Onset of Action	Onset occurs within 1–2 minutes after intravenous injection, corresponding to peak contrast enhancement in the liver during ultrasound imaging.
Duration of Action	Duration of diagnostic enhancement lasts approximately 30–60 minutes post-injection, sufficient for liver lesion characterization. No sustained clinical effect is observed beyond imaging.

Classification & Brands

Dosing & administration

0.5 mL intravenous bolus injection, followed by 5 mL saline flush. May repeat once if needed.

Dosage form	FOR SUSPENSION
Renal impairment	No dose adjustment required for renal impairment.
Liver impairment	No dose adjustment required for hepatic impairment.
Pediatric use	Not approved for use in pediatric patients.
Geriatric use	No specific dose adjustment required; use with caution due to potential comorbidity.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for LUMASON (LUMASON).

Breastfeeding	It is unknown if sulfur hexafluoride is excreted in human milk. No M/P ratio available. Caution should be exercised when administered to a nursing woman. Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for LUMASON and any potential adverse effects on the breastfed infant.
Teratogenic Risk	LUMASON (sulfur hexafluoride lipid microspheres) is an ultrasound contrast agent. No adequate and well-controlled studies in pregnant women. Animal studies show no evidence of fetal harm. Risk cannot be ruled out; use only if clearly needed. First trimester: avoid unless essential. Second and third trimesters: consider risk-benefit.

Warnings & precautions

■ FDA Black Box Warning

WARNING: SERIOUS CARDIOPULMONARY REACTIONS. Serious cardiopulmonary reactions, including fatalities, have occurred during or within 30 minutes following administration of LUMASON. These reactions include fatal cardiac arrest, shock, anaphylaxis, respiratory arrest, and hypoxia. Always have resuscitation equipment and trained personnel readily available.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Known or suspected hypersensitivity to sulfur hexafluoride or any component of LUMASON","Intracardiac shunts (right-to-left, bidirectional, or transient right-to-left shunts)"]

Clinical Precautions

Precautions

["Serious cardiopulmonary reactions: Monitor patients during and for at least 30 minutes after administration","Hypersensitivity reactions: May include anaphylaxis, angioedema, and bronchospasm","Risk of embolism in patients with unstable cardiopulmonary conditions","Extravasation and injection site reactions","Limited clinical data in patients with severe heart failure or pulmonary hypertension"]

Clinical Tips & Counseling

Drug interactions

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LUMASON

Clinical safety rating: caution

Comprehensive clinical and safety monograph for LUMASON (LUMASON).

How it works

What the body does with it

Metabolism	Sulfur hexafluoride is eliminated unchanged via the lungs. The lipid shell components are metabolized via normal lipid pathways.
Excretion	Primarily renal; >90% excreted unchanged in urine within 24 hours. Fecal elimination is negligible (<1%).
Half-life	Terminal elimination half-life is approximately 2 hours (range 1.5–2.5 hours) after intravenous administration, reflecting rapid clearance and supporting use as a diagnostic agent without significant accumulation.
Protein binding	Protein binding is negligible (<5%); predominantly bound to albumin if any, but essentially free in plasma.
Volume of Distribution	Volume of distribution is approximately 0.3 L/kg (range 0.2–0.4 L/kg), consistent with distribution primarily in the extracellular fluid and minimal tissue binding.
Bioavailability	Bioavailability is 100% via intravenous route, as it is administered as an IV injection. Oral bioavailability is not applicable.
Onset of Action	Onset occurs within 1–2 minutes after intravenous injection, corresponding to peak contrast enhancement in the liver during ultrasound imaging.
Duration of Action	Duration of diagnostic enhancement lasts approximately 30–60 minutes post-injection, sufficient for liver lesion characterization. No sustained clinical effect is observed beyond imaging.

Classification & Brands

Dosing & administration

0.5 mL intravenous bolus injection, followed by 5 mL saline flush. May repeat once if needed.

Dosage form	FOR SUSPENSION
Renal impairment	No dose adjustment required for renal impairment.
Liver impairment	No dose adjustment required for hepatic impairment.
Pediatric use	Not approved for use in pediatric patients.
Geriatric use	No specific dose adjustment required; use with caution due to potential comorbidity.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for LUMASON (LUMASON).

Breastfeeding	It is unknown if sulfur hexafluoride is excreted in human milk. No M/P ratio available. Caution should be exercised when administered to a nursing woman. Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for LUMASON and any potential adverse effects on the breastfed infant.
Teratogenic Risk	LUMASON (sulfur hexafluoride lipid microspheres) is an ultrasound contrast agent. No adequate and well-controlled studies in pregnant women. Animal studies show no evidence of fetal harm. Risk cannot be ruled out; use only if clearly needed. First trimester: avoid unless essential. Second and third trimesters: consider risk-benefit.

Warnings & precautions

■ FDA Black Box Warning

Side Effect Profile

Serious Effects

Absolute Contraindications

["Known or suspected hypersensitivity to sulfur hexafluoride or any component of LUMASON","Intracardiac shunts (right-to-left, bidirectional, or transient right-to-left shunts)"]