Iodixanol

Indications

Iodixanol is used for: Radiographic contrast medium for diagnostic procedures

Adult Dose

Iodixanol 320 Intra-arterial administration (arteriography) Carotid arteries: 10-14 mL Verterbral arteries: 10-12 mL Right coronary artery: 3-8 mL Left coronary artery: 3-10 mL Left ventricle: 20-45 mL Renal arteries: 8-18 mL Aortography: 30-70 mL Major aorta branch: 10-70 mL Peripheral arteries: 15-30 mL Aortofermoral runoffs: 20-90 mL Intra-arterial administration (IA-DSA) Carotid or vertebral arteries: 5-8 mL Aortography: 10-50 mL Major aorta branch: 2-10 mL Aortofemoral runoffs: 6-15 mL Peripheral arteries: 3-15 mL IV administration CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion not to exceed 150 mL Excretory urography: 1 mL/kg, not to exceed 100 mL Venography: 50-150 mL per lower extremity Iodixanol 270 Intra-arterial administration (IA-DSA) Renal arteries: 10-25 mL Aortography: 20-50 mL Major aorta branches: 5-30 mL IV administration CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion; not to exceed 150 mL Excretory urography: 1 mL/kg; not to exceed 100 mL for normal renal function Venography (per lower extremity): 50-150 mL; not to exceed 250 mL

Child Dose

Intra-arterial administration Iodixanol 320 1-12 years Cerebral, cardiac chambers and related major arteries, and visceral studies: 1-2 mL/kg; not to exceed 4 mL/kg >12 years Carotid arteries: 10-14 mL Verterbral arteries: 10-12 mL Right coronary artery: 3-8 mL Left coronary artery: 3-10 mL Left ventricle: 20-45 mL Renal arteries: 8-18 mL Aortography: 30-70 mL Major aorta branch: 10-70 mL Peripheral arteries: 15-30 mL Aortofermoral runoffs: 20-90 mL Intra-arterial administration (IA-DSA) Iodixanol 320 >12 years Carotid or vertebral arteries: 5-8 mL Aortography: 10-50 mL Major aorta branch: 2-10 mL Aortofemoral runoffs: 6-15 mL Peripheral arteries: 3-15 mL IV administration Iodixanol 320 >12 years CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion not to exceed 150 mL Excretory urography: 1 mL/kg, not to exceed 100 mL Venography: 50-150 mL per lower extremity Intra-arterial administration (IA-DSA) Iodixanol 270 1-12 years CECT or excretory urography: 1-2 mL/kg; not to exceed 2 mL/kg >12 years Renal arteries: 10-25 mL Aortography: 20-50 mL Major aorta branches: 5-30 mL IV administration Iodixanol 270 >12 years CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion; not to exceed 150 mL Excretory urography: 1 mL/kg; not to exceed 100 mL for normal renal function Venography (per lower extremity): 50-150 mL; not to exceed 250 mL

Renal Dose

Administration

Contra Indications

In the pediatric population prolonged fasting and the administration of a laxative before injection are contraindicated.

Precautions

Maintain adequate hydration Use caution in renal/hepatic impairment, cardiovascular disease, multiple myeloma, pheochromocytoma, sickle cell disease, elderly patients, and thyroid dysfunction Increased risk of adverse effects including heart disease, renal dysfunction, asthma patients, and sensitivity to allergens or medications Lactation: Excretion in breast millk unknown; not recmmended

Pregnancy-Lactation

Pregnancy There are no data with iodixanol use in pregnant women to inform any drug-associated risks; in animal reproduction studies, no developmental toxicity occurred with intravenous iodixanol administration to rats and rabbits at doses up to 0.24 (rat) or 0.48 (rabbit) times the maximum recommended human intravenous dose Lactation There are no data on presence of iodixanol in human milk, the effects on breastfed infant or effects on milk production. Iodinated contrast agents are poorly excreted into human milk and are poorly absorbed by gastrointestinal tract of a breastfed infant; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for iodixanol and any potential adverse effects on breastfed infant from iodixanol or from underlying maternal condition Interruption of breastfeeding after exposure to iodinated contrast agents is not necessary because the potential exposure of breastfed infant to iodine is small; however, a lactating woman may consider interrupting breastfeeding and pumping and discarding breast milk for 10 hr (approximately 5 elimination half-lives) after iodixanol administration in order to minimize drug exposure to a breast fed infant

Interactions

Adverse Effects

Side effects of Iodixanol : Body as a Whole—General Disorders: back pain, fatigue, malaise. Cardiovascular Disorders: arrhythmias, cardiac failure, conduction abnormalities, hypotension, myocardial infarction. Nervous System: cerebral vascular disorder, convulsions, hypoesthesia, stupor, confusion. Gastrointestinal System Disorders: dyspepsia. Hypersensitivity Disorders: pharyngeal edema. Respiratory System Disorders: asthma, bronchitis, dyspnea, pulmonary edema, rhinitis. Renal System Disorders: abnormal renal function, acute renal failure, hematuria. Peripheral Vascular Disorders: flushing, peripheral ischemia. Skin and Appendage Disorders: hematoma, increased sweating. Special Senses, Other Disorders: tinnitus. Vision Disorders: abnormal vision.

Mechanism of Action

Dimeric, isosmolar, nonionic, water-soluble, iodinated x-ray contrast agent for intravascular administration; opacifies vessels within path of flow, thereby permitting radiographic visualization of internal structures until significant dilution and elimination occurs.