1590 Contrast Media
myelography, but was associated with serious adverse iodine) and the dose and strength used vary according to the Omnipaque; Switz.: Accupaque; Omnipaquet; Thai.: Iobrix; effects, including allergy, arachnoiditis, and aseptic mening� procedure and the route. Turk.: Kopaq; Omnipaque; UK: Omnipaque; Ukr. : Omnipaque itis, and has now been superseded by nonionic media. (OMHnnaK); Tomohexol (ToMoreKcon); Unipak (IOmmaK); USA: Residues of iofendylate remaining years after myelography Adverse Effects, Treatment, and Precautions Omnipaque. have been associated with adverse effects. Other former PharmacopoeialPreparations Iohexol and other nonionic iodinated contrast media have uses included ventriculography, and visualisation of the USP 36: Iohexol Injection. fetus in the amniotic sac. similar adverse effects and precautions to ionic media but the effects tend to be less severe and the incidence is Preparat ons generally lower; see under the amidotrizoates, p. 1582.1 lomeproi (BAN, USAN, r/NN) i and p. 1583.1 for details. Pharmacopoeial Preparations Additional neurological adverse effects may occur when iomeprol; lomeprolum; Jo:;rleproi; Jomeprol� !�of,AenpOJI. BP 2014: Iofendylate Injection; nonionic media such as iohexol are used for myelography. 1!/, -N' Bis(2,3-aihydrox-ypropyl)� 2.4,6•triiodl75-{JY:methy.lg1y" USP 36: Iophendylate Injection. These include severe headache, backache, neck stiffness, colafl"lidoH.>ophtbalamide. dizziness, and leg or sciatic-type pain. Convulsions, aseptic G07H221,N,Oe;-'77:71 meningitis, and mild and transitory perceptual aberrations, CAS � such as visual and speech disturbances, and confusion, may 78ft4 9-4 1-9. .{{TC � V0 84BJ O. occur occasionally; rarely, more severe mental disturbances ATCVet ...;.;. QVQ8ABW. have occurred. Urinary retention has also been reported. UN!r� 17ti 1JBP8L Breast feeding. Iohexol is distributed into breast milk in Description. Iorneprol contains about 49% of I. very small quantities1 but no adverse effects have been seen in breast-feeding infants whose mothers were receiv Uses and Administration ing iohexol and the American Academy of Pediatrics con siders2 that it is therefore usually compatible with breast Iomeprol is a nonionic monomeric iodinated radiographic feeding. contrast medium (p. 1580.1 ). It may be given intravenously, intra-arterially, intrathecally, or by instillation into body 1. Nielsen ST, et a!. Excretion of iohexol apd metrizoate in human breast milk. Acta Radiol 1987; 28: 523-6. cavities, and is used in radiographic procedures including 2. American Academy of Pediatrics. The transfer of drugs and other myelography, angiography, urography, and arthrography. chemicals into human mille Pediatrics 2001; 108: 776-89. [Retired May It is also used to produce contrast enhancement during 20101 Correction. ibid.; 1029. Also available at: http://aappolicy. computed tomography. a appub lications. org/ cgi f content /full/pedia tries% 3 b 1 08/3/776 (accessed 27/03/06) Iomeprol is usually available as solutions containing 30.62 to 81.65% of iomeprol (equivalent to 150 to Effects on the nervous system. Encephalopathy developed 400 mg/mL of iodine) and the dose and strength used vary in a 48-year-old man with sciatica within 9 hours of according to the procedure and the route. iohexol for lumbar myelography but had largely resolved Reviews. 48 hours after the myelogram; complete resolution took 4 1. Dooley M, Jarvis B. Iomeprol: a review of its use as a contrast medium. days.1 However, recovery was slow in a patient who Drngs 2000; 59: 1169-86. developed paraplegia and areflexia in the legs after a simi lar procedure. Five months later the patient still com Adverse Effects, Treatment, and Precautions plained of paraesthesia in her legs and could not stand As for the amidotrizoates, p. 1582.1 and p. 1583.1. For without support.2 Encephalopathy has also been reported adverse effects relating to the use of nonionic contrast media in association with use of iohexol for coronary angiogra such as iomeprol for myelography, see under 1ohexol phy.' (above). L Donaghy M, et at. Encephalopathy after iohexol myelography. Lancet 1985; ii: 887. 2. Noda K. et al. Prolonged paraplegia alter iohexol myelography. Lancet Porphyria. The Drug Database for Acute Porphyria, com 1991; 337: 681. piled by the Norwegian Porphyria Centre (NAPOS) and 3. Sawaya RA, et al. Contrast-induced encephalopathy following coronary the Porphyria Centre Sweden, classifies iomeprol as not angioplasty with iohexol. South Med J 2007; 100: 1054-5. porphyrinogenic; it may be used as a drug of first choice and no precautions are needed.1 Porphyria. The Drug Database for Acute Porphyria, com I. piled by the Norwegian Porphyria Centre (NAPOS) and The Drug Database for Acute Porphyria. Available at: http://www. drugs-porphyria.org (accessed 18/10/11) the Porphyria Centre Sweden, classifies iohexol as not por phyrinogenic; it may be used as a drug of first choice and Profile no precautions are needed.1 Pharmacokinetics Ioglicic acid is an ionic monomeric iodinated radiographic J. The Drug Database for Acute Porphyria. Available at: http:ffwww. After intravascular use, iomeprol is rapidly eliminated contrast medium (p. 1580.1) that has been used, as the drugs-porphyria.org (accessed 18/10/ll) unchanged in the urine, with a terminal elimination half meglumine and sodium salts, for diagnostic procedures. life of I.9 hours. It is not significantly bound to plasma Interactions proteins. P epa at ons Antiarrhythmics. A small retrospective study1 found that ...... r r...... i ...... concurrent use of iohexol and amiodarone resulted in sig Proprietary. Preparations (details are given in Volume B) nificant prolongation of the QTc interval compared with iohexol alone. Caution was advised irl the use of iohexol Single-ingredient Preparations. Austral. : Iomeron; Austria: Iomeron; Belg. : Iomeron; China: Iomeron Cz. : lamer in patients taking antiarrhythmics that prolong QT inter (fl�-iliffi-); on; Denm.: Iomeron; Fin.: Iomeron; Fr.: Iomeron; Ger.: !mer val. on; Gr.: Iomeron; Hong Kong: Iomeront; Hung.: Iomeron; Irl. : 1. Goernig M, et at. Iohexol contrast medium induces QT prolongation in Iomeron; Israel: Iomeron; Ital. : Iomeron; Jpn: Iomeron; Neth.: amiodarone patients. Br J Clin Pharmacal 2004; 58: 96-8. Iomeron; Norw.: Iomeron; NZ: Iomeron; Port. : Iomeron; Spain: Iomeron; Swed.: Iomeron; Switz.: Iomeron; Turk.: Pharmacokinetics Iomeron; UK: Iomeron. After intravascular use, 90% or more of a dose of iohexol is Description. Iohexol contains about 46.4% of I. eliminated unchanged in the urine within 24 hours. An Pharmacopoeias. In Eur. (see p. vii), Int., and US. elimination half-life of about 2 hours in patients with lopamidol (BAN, USAN, r!NN) Ph. Eur. 8: (lohexol). A white or greyish-white, hygroscopic normal renal function has been reported. Protein binding in B-l s o; ! pamidoium;·· J a idoti;Jopamf<:J<)Iis powder. Very soluble in water; practically insoluble in blood is reported to be very low. oo o Jopamidoi; ()p m $Q-13-?Q6; MonaMt4i1on. dichloromethane; freely soluble in methyl alcohol. Store in (5)-N,N'.-Bis!2-hydroxy·l.-(hy<_lroxy(f1<;thyi)ethylJ,2,4,(j-tri" airtight containers. Protect from light. Pregnancy. Contrast material was detected1 in the intes p USP 36: tines of twin neonates who were born 17 hours after iocjo-5�iactamidoi�o htha!arnid!!. (Iohexol). A white to off-white, hygroscopic, Co·H,,I,NaOtF7V7.1 odourless powder. Very soluble in water and in methyl iohexol was given to their mother for angiography, sug C.l\5 60 166c93-0: 6288:1 -0U
All cross-references refer to entries in Volume A USP 36: (Iopanoic Acid). A cream-coloured powder, with a lopodic Acid (BANM, rtNNM) Uses and Administration faint characteristic odour. Insoluble in water; soluble in i�P��idol is a nonionic monomeric iodinated radiographic alcohol, in chloroform, in ether, and in solutions of alkali Acide ·· lopo<;lique; .fiu;iqo · i¢p0dico; . .Acidum lopodicum; contrast medium (p. 1 580.1). It may be given intravenously, hydroxides and carbonates. Store in airtight containers. Jop6dlto, �cido;Jpddic Acid; Jilonogoea&· Kw:nora. intra-arterially, intrathecally, intra-articularly, orally, or Protect from light. 3-(3-Dlmethylarninomethyleneamlno-2,4,6-tri-iodophenyl) rectally and is used in radiographic procedures including p.riJpionic add, urography, and angiography, arthrography, myelography, Profile c,H,;hi!l,b1,;soo:o imaging of the gastrointestinal tract. Iopamidol is also used OS ....:. 558?·89-:3. for contrast enhancement during computed tomography. Iopanoic acid is an ionic monomeric iodinated radiographic Iopamidol is usually available as solutions containing contrast medium (p. 1580.1). It has been given orally for �����t�:��OeACIO. of iopamidol (equivalent to 150 to 30.62 to 75.5 % cholecystography and cholangiography in usual doses of 3 g, 1��UNii - P6 04ZK/9l(J. 370 mg/mL of iodine) and the dose and strength used vary with plenty of water, about 10 to 14 hours before X-ray according to the procedure and route. examination. Iopanoic acid has also been used in the management of Calcium lopodate (BANM, r/NNM) Gastrointestinal obstruction. Enemas of iopamidol were hyperthyroidism (see below). Calcii p da ; Calcium lopodate Calcique; considered safe and effective in the management of meco lo o s ipodate; lopodato caicico; lpodate . Calcium; Kalciumjopqdat; nium ileus in extremely low-birth-weight infants.1 • Breast feeding. No adverse effects have been seen in Kalsiumjopodaar.ti; il1onoAaT. · 1 Nakaoka T, eta!. Iopamidol enema treatment for meconi�m obstruction 1\a!lbl!Miil . breast-feeding infants whose mothers were receiving iopa of prematurity in extremely low-birth weight inlants: a sa'fe and effective (C,H,2f,N,02hCa"- 1134.0 . . noic acid and the American Academy of Pediatrics consid method. Pediatr Surg Int 2009; 25: 273-6. 0\5 --: i/51:T1·7. ers1 that it is therefore usually compatible with breast ATC - V08A CIO: feeding. e.CJ.t ent, CJ.��-�r.e.cautio_�_s ATC Vet - QV08AC10. Adverse Effects, Tr rT_J .... I. · . American Academy of Pediatrics. The transfer of drugs and other UNII --:--.505 7W5M9Zl. :;:; f;r ;he amidotrizoates, p. 1582.1 and p. 1583.1. For the chemicals into human milk. Pediatrics 2001; 108: 776-89. [Retired May 2010} Correction. ibid.; 1029. Also available at: http://aappolicy. effects relating to the use of nonionic contrast media Description. Calcium iopodate contains about 61.7% of I. adverse aappublications.org/cgi/content/full/pediatrics%3bl08/3/776 (accessed see under Iohexol, , such as iopamidol for myelography, 27/03/06) p. 1590.2; for specific references, see below. Sodium lopodate (BAN, riNN) Hyperthyroidism. lopanoic acid and other iodinated oral IQpodate d<;; ?odium; lQ1)oda.tn de s.OcJj(};,lpodate SOGII'um. on the nervous system. Reports1·6 of serious neu Effects cholecystographic agents reduce conversion of thyroxine (USAN); Natrii Jopodas; Natriurnto p&iaatti; Natriumjopodat; rological sequelae to lumbar myelography with iopamidol. to tri-iodothyronine, as well as inhibiting release of thy lpodate;:HacpwCl lilof!dAaT. wallers K, et al. Severe meningeal irritation after intrathecal injection of J NSC:10P'962; Soclium 1. roid hormones from the thyroid gland, 1 and they have iopamidol. BMJ 1985; 291: 1688. c,,H,21JN)'iaOp6l9,9. reaction to iopamidol. Med J Aust 1986; 144: been used in the manage1nent of hyperthyroidism 2. Robinson C, Fon G. Adverse 0\S - 1121-56·;1. 553. (p. 2332.2). lopanoic acid has been used successfully for lateral rectus palsy associated ATC- V08A C08. 3. Bell JA, Mcilwaine GG. Postmyelographic pre-operative preparation in severe hyperthyroidism,2·4 with iopamidol. BMJ 1990; 300: 1343-4. ATC Ver - Qli08AC08. after iopamidol and for control of hyperthyroidism before radio-iodine 4. Mallat z, et a!. Aseptic meningoencephalitis UNII - F3115LLW9W1N. myelography. Lancet 1991; 338: 252. treatroent.5 It has a rapid effect but rebound hyperthyroid Lancet 1991; 338: Description. Sodium iopodate contains about 61.4% of I. 5. Bain PG, et al. Paraplegia after iopamidol myelography. ism may occur and it is not generally suitable for long 252-3. term use.1 In US. induced by iopamidol Pharmacopoeias. 6. Klein KM, et al. Status epilepticus and seizures J. Braga M, Cooper DS. Oral cholecystographic agents and the thyroid. J myelography. Seizure 2004; 13: 196-9. USP 36: (Ipodate Sodium). A fine, white or off-white, Clin Endocrinol Metab 2001; 86: 1853-60. odourless, crystalline powder. Soluble 1 in less than I of 2. Pandey CK, et al. Rapid preparation of severe uncontrolled thyrotoxic The Drug Database for Acute Porphyria, com Porphyria. osis due to Graves' disease with iopanoic acid-a case repon. Can J water, I in 2 of alcohol, I in 2 of dimethylacetarnide, and I piled by the Norwegian Porphyria Centre (NAPOS) and Anesth 2004; 51: 38--40. in 3.5 of dimethylformamide and of dimethyl sulfoxide; the Porphyria Centre Sweden, classifies iopamidol as not 3. Dhillon KS, et al. Treatment of hyperthyroidism associated with very slightly soluble in chloroform; freely soluble in methyl thyrotropin-secreting pituitary adenomas with iopanoic acid. J Clin porphyrinogenic; it may be used as a drug of first choice � alcohol. Store in airtight containers. Endocrinol Metab 2004; 89: 708-1 1. and no precautions are needed.1 4. Panzer C, et al. Rapid preoperative preparation for severe hyperthyroid 1. The Drug Database for Acute Porphyria. Available at: http:flwww. Graves' disease. J Clin Endocrinol Metab 2004; 89: 2142-4. Profile drugs-porphyria.org (accessed 18Jl0/l 1) 5. Bal CS, et al. Effect of iopanoic acid on radioiodine therapy of hyperthyroidism: long-term outcome of a randomized controlled trial. J Iopodic acid is an ionic monomeric iodinated radiographic Clin Endocrinol Metab 2005; 90: 6536-40. Pharmacokinetics contrast medium (p. 1580.1). It has similar properties to iopanoic acid (above) and has been used orally as the On intravascular use, iopamidol is rapidly eliminated, with Preparations sodium or calcium salt for cholecystography and ...... up to 50% of the dose recovered unchanged in the urine ...... cholangiography. It has also been tried in the management Proprietary Preparations (details are given in Volume B) within 2 hours; the elimination half-life is about 2 hours. It of hyperthyroidism. is not significantly bound to plasma proteins. Single·ingredient Preparations. India: lopac; Spain: Colegraft. i Pre r�t ()n.� . Pharmacopoeial Preparations p� ...... Proprietary Preparations (details are given in Volume B) . _ _ .. BP 2014: Iopanoic Acid Tablets; P�prietary Preparations (details are given in Volume B) USP 36: Iopanoic Acid Tablets. Single·ingredient Preparations. Gr.: Biloptin. Single-ingredient Preparations. Arg.: Hemoray; Iopamiron; Opa Pharmacopoeial Preparations crile; Austral. : Isovuet; Austria: Gastromiro; Jopamiro; Scan USP 36: Ipodate Sodium Capsules. lux; Braz. : Iopamiron; Canad.: Isovue; Chile: Radiomiron; (BAN, USAN, r/NN) China: Iopamiro (fil!..rt.?R); Cz. : Iopamigita; Scanlux; Fr. : Iopa lopentol miron; Ger. : Iopamigita; Iopathek; Solutrast; Unilux; Gr.: Iopa Compound lopentolum; Jqpentol; Jopentoli; VlopeH· miro; Radoso; Scanlux; Hong Kong: Iopamirot; Hung. : Iopa (BAN, USAN, r!NN) TOJ1. lopromide Scanlux; Irl. : Gastromiro; Niopam; Israel: Iopamiro; !tal.: miro; topromid; iopromida; lopromic;!um;Joproml;:!;Jopromidi; ZK- Gastromiro; Iopamiro; Iopasen; Scanlux; Mex. : Pamirayt; N,f\f·l3is(2,3·dihydro xypropyl}-f?-[N·(2-hydroxy-3:methoxy- · lilonp6MVi,il. . . . • Ne th.: Gastromiro; Iopamigita; Iopamiro; Scanluxt; NZ: Iopa propyt)acetarnldoj-2,4,6-tri-iod<)isophtha!amide. 35760; -Sis(2,3·dihydroxypropyi):1,4,6-ui-icido-S·(2"methoxya· mirot; Isovue; Port. : Gastromiro; Iopamiro; Scanlux; Rus.: C20H2;11N;Or835.2 N,N' Iopamiro (tionaMHpo); Singapore: Iopamiro; Spain: Iopamiro; CAS- 89l91-oG�2. cetamido)-N-mettJy,lisopf1thalamide, Scanlux; Switz.: Iopamiro; Scanlux; Turk.: Iopamiro; Mino A TC - V081\808. c.H,.;13N,0,:791.1 triyod; Pamiray; UK: Gastromiro; Niopam; Scanlux; USA: !so A(C \fet � QV08AB08. CA S -- 73334-{)7-3. vue; Venez. : Iopamiron. tJf\111- JD6 XWX0 16 T ATC ---: V08A805. Pharmacopoeial Preparations Description. lopentol contains about 45.6% of I. ATCVet- QV08A B05. BP 2014: Iopamidol Inj ection; Iopamidol Oral Solution; UNII.� 7f28AC33Mt. USP 36: Iopamidol Injection. Profile Description, Ioprornide contains about 48. 1% of I. Pharmacopoeias.In Eur. (see p. vii) and US. Iopentol is a nonionic monomeric iodinated radiographic (BAN, r!NN) Ph. Eur. 8: (Iopromide). Iopromide is a mixture of lopanoic Acid . . . contrast medium (p. 1580.1). It may be given intravenously, diastereoisomers and atropisomers. A white or slightly iopanoico; l noicum; intra-arterially, orally, or by instillation into body cavities, Acide iopanofque; Acido Acidum opa yellowish powder. Freely soluble in water and in dimethyl and is used in procedures including angiography, lodopanoic AGid; lopanoico; acioo; lopansaure; :fopaanihap sulfoxide; practically insoluble in alcohol and in acetone. Kyselina jopanoova; arthrography, endoscopic retrograde cholangiopancreato po; Jopano rtig�tis; Jopansav; Jopar�syra; Protect from light. Kv;cnoTa. graphy, hysterosalpingography, urography, and visualisa lilonaHoesafl USP 36: (Iopromide). A white to slightly yellow powder. 1·(3cAmino·2A.6�trHodobenzyl)butyric acid. tion of the gastrointestinal tract. It is also used for contrast enhancement in computed tomography. Freely soluble in water and in dimethyl sulfoxide; C,H121,N0;=570.9 lopentol is usually available as solutions containing 32.9 practically insoluble in alcohol, in acetone, and in ether. - 0\S 96-83-3. to 76.8% of iopentol (equivalent to !50 to 350mg/mL of Protect from light. ATC -·· VCI$AC06. iodine) and the dose and strength used vary according to the ATC Vet -· QV08A(06. procedure and route. Uses and Administration UNil - FE97B4 P7 U Iopromide is a nonionic monomeric iodinated radiographic Description. Iopanoic acid contains about 66.7% of I. Preparations contrast medium (p. 1 580.1 ). It may be given intravenously, ...... Pharmacopoeias. In Ch in., Bur. (see p. vii), In t., and US. intra-arterially, or by instillation into body cavities, and is Proprietary Preparations (details are given in Volume B) Ph. Eur. 8: (Iopanoic Acid). A white or yellowish-white used in procedures including angiography, arthrography, powder. Practically insoluble in water; soluble in Single·ingredient Preparations. Austria: lmagopaquet; Fr. : Ive hysterosalpingography, urography, and assessment of dehydrated alcohol and in methyl alcohol; dissolves in paquet; Gr.: Imagopaque. dialysis shunt patency. It is also used for contrast dilute solutions of alkali hydroxides. Protect from light. enhancement during computed tomography.
The symbol t denotes a preparation no longer actively marketed