Drug information of iohexol (Omnipaque)

iohexol (Omnipaque)

Drug group:

Iohexol is an effective non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiographic procedures. It is low systemic toxicity is the combined result of low chemotoxicity and low osmolality

Mechanism of effect

Organic iodine compounds block x-rays as they pass through the body, thereby allowing body structures containing iodine to be delineated in contrast to those structures that do not contain iodine.
The degree of opacity produced by these compounds is directly proportional to the total amount (concentration and volume) of the iodinated contrast agent in the path of the x-rays. After intravascular administration, iohexol makes opaque those vessels in its path of flow, allowing visualization of the internal structures until significant hemodilution occurs.

Pharmacodynamic

It is used before an x-ray or an alike test . Allows for radiographic visualization through the opacification of vessels and anatomical structures in the path of flow of the contrast media

Pharmacokinetics

Absorption : any medium retained in the uterine or peritoneal cavity is absorbed systemically within 60 minutes. May not be absorbed for up to 24 hours if tubes are obstructed and dilated.
Protein binding : Minimal
Excretion : Urine (80-90%)
Duration : 30 min following intrathecal administration, 60 min following IV administration; 15-120 seconds in serum

Dosage

tell your doctor:
• If you have an allergy to iohexol or any other part of iohexol .
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you are dehydrated, have been eating poorly, or have used a laxative or water pill before this medicine.
• If you have had a skin reaction to iohexol or another drug like it in the past.
• If you are taking metformin, talk with doctor.
• Thyroid problems have happened after use of this medicine. Some people had to be treated for these thyroid problems. Talk with the doctor. Dosage injection solution
• 180mg/mL
• 240mg/mL
• 300mg/mL
intravenous solution:140mg/mL و350mg/mL
powder for oral solution (Oraltag)
9.7g/bottle (equivalent to 4.5g carbon bound iodine)
There are 5 fill lines premolded on the bottle for accurate dilution of the product to a desired concentration
Intrathecal
Omnipaque 180 (180 mgI/mL)
Lumbar Myelography, via lumbar injection 10-17 mL
Cervical Myelography, via C1-C2 injection: 7-12.5 mL
Omnipaque 240 (240 mgI/mL)
Lumbar Myelography, via lumbar injection: 7-12.5 mL
Thoracic Myelography, via lumber/cervical injection: 6-12.5 mL
Cervical Myelography, via lumbar injection: 6-12.5 mL; via C1-C2 injection: 6-12.5
Total Columnar Myelography, via lumbar injection: 6-12.5 mL
Omnipaque 300 (300 mgI/mL)
Thoracic Myelography, via lumbar/cervical injection: 6-10 mL
Cervical Myelography, via lumbar injection: 6-10 mL; via C1-C2 injection: 4-10 mL
Total Columnar Myelography, via lumbar injection: 6-10 mL
Administration
Rate of injection: Slowly over 1-2 min
Not to exceed 300 mg/mL or 3060 mg iodine per single myelographic procedure
Intravascular
Omnipaque 140/300/350
Angiocardiography: ventriculography, pulmonary arteriography, venography & studies of collaterol arteries
• Ventriculography: 40 mL, range of 30-60 mL; may be repeated as needed, not to exceed 250 mL
• Selective Coronary Arteriography: 5 mL. range 3-14 mL per injection
• Aortic Root and Arch Study: 50 mL, range 20-75 mL, when used alone
• Pulmonary Angiography: 1 mL/kg
• Combined Angiographic Procedures: Multiple Procedures not to exceed 5 mL/kg or 250 mL
• Aortography and Selective Arteriography
• - Aorta: 50-80 mL
• - Major branches incl celiac, mesenteric arteries: 30-60 mL
• - Renal arteries: 5-15 mL; not to exceed 291 mL/Omnipaque 300 or 250 mL/Omnipaque 350 when repeat injection indicated
• Cerebral Arteriography: Common Carotid Artery: 6-12 mL
• Internal Carotid Artery: 8-10 mL
• External Carotid Artery: 6-9 mL
• Vertebral Artery: 6-10 mL
CT Scanning of the Body
Head Imaging via injection: 70-150 mL (Omni 300); 80 mL (Omni 350)
Head Imaging via infusion: 120-250 mL (Omni 240)
Body Imaging via injection: 50-200 mL (Omni 300); 60-100 mL (Omni 350)
Digital Subtraction
Omni 350
• Usual amount used for IV digital technique is 30-50 mL
• Administer as bolus at 7.5-30 mL/sec using pressure injector
Omni 140
• Intra-arterial use for head, neck, abdominal, renal, and peripheral vessel
• Administer 1 or more bolus via intra-arterial injection of Omni 140
• Aorta: 20-45 mL at 8-20 mL/sec
• Carotid: 5-10 mL at 3-6 mL/sec
• Femoral: 9-20 mL at 3-6 mL/sec
• Vertebral: 4-10 mL at 2-8 mL/sec
• Renal: 6-12 mL at 3-6 mL/sec
• Other Branches of Aorta: 8-25 mL at 3-10 mL/sec
GI Tract
o Omni 350 (undiluted): 50-100 mL, dependent on nature of procedure and patient size
Intracavity
Usual: 50-150 mL IV OR 100-250 mL IV of (240 mgI/mL)
Hysterosalpingography
• Omnipaque 240: 15-20 mL, but varies with anatomy and/or disease state
• Omnipaque 300: 15-20 mL, but varies with anatomy and/or disease state
Body Imaging
25-75 mL IV OR 50-150 mL IV infusion; not to exceed 150 mL
For 240 mg/mL: 35-100 mL IV OR 70-200 mL IV infusion; not to exceed 250 mL
Oral
Oraltag
• Indicated for opacification of the GI tract during CT of the abdomen and pelvis
• 1-2 bottles of prepared solution (4.5-9 g iodine) PO 20-60 minutes before image acquisition

Drug contraindications

Anuria

Alerts

1. Inhibits blood coagulation
2. Patient should be well hydrated before and after procedure
3. Caution in severe renal impairment, combined renal/hepatic disease, severe thyrotoxicosis, multiple myeloma, anuria, pheochromocytoma, sickle cell, CHF, severe arterial/venous disease
4. May cause renal failure in patients advanced vascular disease, diabetes; should be well hydrated before/after procedure
5. Hypersensitivity to contrast medium, iodine
6. Focal and generalized motor seizures reported patients with history of epilepsy when higher than recommended doses used
7. Allergies (bronchial asthma, hay fever, food allergies)
8. Serious and fatal thromboembolic events causing myocardial infarction or stroke reported during angiographic procedures
9. Severe cutaneous adverse reactions(SCAR), including Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms (DRESS), may develop from 1 hr to several weeks after intravascular contrast agent administration; reaction severity may increase and time to onset may decrease with repeat administration of contrast agent;
10. prophylactic medications may not prevent or mitigate severe cutaneous adverse reactions; avoid administering product to patients with history of severe cutaneous adverse reaction to product

Points of recommendation

tell your doctor:
• If you have an allergy to iohexol or any other part of iohexol .
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you are dehydrated, have been eating poorly, or have used a laxative or water pill before this medicine.
• If you have had a skin reaction to iohexol or another drug like it in the past.
• If you are taking metformin, talk with doctor.
• Thyroid problems have happened after use of this medicine. Some people had to be treated for these thyroid problems. Talk with the doctor.

Pregnancy level

B


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