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Iohexol: Side Effects, Uses, Dosage, Interactions, Warnings

Iohexol

What Is Iohexol and How Does It Work?

Iohexol is a radiographic contrast medium indicated for intrathecal administration in adults including myelography (lumbarthoraciccervical, total columnar) and in contrast enhancement for computerized tomography (myelography, cisternography, ventriculography).

What Are the Dosages of Iohexol?

Dosages of Iohexol

Dosage Forms & Strengths

Injection Solution

  • 180mg/mL
  • 240mg/mL
  • 300mg/mL

Intravenous Solution

  • 140mg/mL
  • 350mg/mL

Powder for Oral Solution (Oraltag)

  • 9.7g/bottle (equivalent to 4.5g carbon bound iodine)
  • The packaging allows for the preparation of the iohexol in a single-use bottle
  • There are 5 fill lines premolded on the bottle for accurate dilution of the product to the desired concentration

What Are Side Effects Associated with Using Iohexol?

Side effects of iohexol include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Iohexol?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

  • Iohexol interaction with other drugs is not known at this time.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Iohexol?

Warnings

Contraindications

  • For procedural contraindications see package insert
  • Intrathecal administration of corticosteroids with Omnipaque
  • Intrathecal administration of OMNIPAQUE 140 and OMNIPAQUE 350
  • Parenteral administration of OMNIPAQUE oral solution 9 and 12
  • DO NOT immediately repeat myelography because of technical problem (see Dosing)
  • Significant bacterial infection

OMNIPAQUE body cavity 240 and 300 for hysterosalpingography

  • During pregnancy or suspected pregnancy
  • Menstruation or when menstruation imminent
  • Within 6 months after termination of pregnancy
  • Within 30 days after conization or curettage
  • When signs of infection are present in any portion of the genital tract including external genitalia
  • When reproductive tract neoplasia is known or suspected

Cautions

  • Inhibits blood coagulation
  • The patient should be well hydrated before and after the procedure
  • Caution in severe renal impairment, combined renal/hepatic disease, severe thyrotoxicosis, multiple myeloma, anuria, pheochromocytoma, sickle cell, CHF, severe arterial/venous disease
  • May cause renal failure in patients advanced vascular disease, diabetes; should be well hydrated before/after the procedure
  • Hypersensitivity to contrast medium, iodine
  • Hydrate patients before and after examination
  • Use extreme caution in pheochromocytoma
  • Focal and generalized motor seizures reported patients with a history of epilepsy when higher than recommended doses used
  • If immediate, transient pain occurs during hysterosalpingography, monitor injection pressure and volume instilled to minimize pain and to avoid disruptive distention of uterus and fallopian tubes; fluoroscopic monitoring recommended
  • Allergies (bronchial asthma, hay fever, food allergies)
  • Serious and fatal thromboembolic events causing myocardial infarction or stroke reported during angiographic procedures
  • Acute renal failure reported in diabetic patients with diabetic nephropathy and in susceptible nondiabetic patients (often elderly with preexisting renal disease) following excretory urography; careful consideration of potential risks should be given before performing the radiographic procedure in these patients
  • 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; prophylactic medications may not prevent or mitigate severe cutaneous adverse reactions; avoid administering the product to patients with a history of severe cutaneous adverse reaction to the product

Pregnancy & Lactation

  • Postmarketing data with use in pregnant women are insufficient to determine if there is a drug-associated risk of adverse developmental outcomes; drug crosses the placenta and reaches fetal tissues in small amounts; in animal reproduction studies, no adverse developmental effects were observed following intravenous administration to pregnant rats and rabbits during organogenesis at doses up to 0.4 (rat) and 0.5 (rabbit) times maximum recommended human intravenous dose
  • Literature reports that breastfeeding after administration to mother would result in the infant receiving an oral dose of approximately 0.7% of maternal intravenous dose; there is no information on effects of the drug on milk production; iodinated contrast agents are excreted unchanged in human milk in very low amounts with poor absorption from the gastrointestinal tract of a breastfed infant; exposure to a breastfed infant can be minimized by temporary discontinuation of breastfeeding; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
  • Interruption of breastfeeding after exposure to iodinated contrast agents is not necessary because potential exposure of the breastfed infant to iodine is small; however, a lactating woman may consider interrupting breastfeeding and pumping and discarding breast milk for 10 hours (approximately 5 elimination half-lives) after drug administration to minimize drug exposure to the breastfed infant
References
https://reference.medscape.com/drug/omnipaque-oraltag-iohexol-343760