Iopamidol


Generic Medicine Info
Indications and Dosage
Intra-arterial
Cerebral arteriography
Adult: As 300 mg iodine/mL solution (61%): 8-12 mL by carotid puncture or transfemoral catheterisation, with total multiple doses ranging to 90 mL. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intra-arterial
Coronary arteriography and ventriculography
Adult: As 370 mg iodine/mL solution (76%): 2-10 mL for selective coronary artery inj; 25-50 mL for ventriculography or nonselective opacification of multiple coronary arteries following inj at the aortic root. Max total: 200 mL. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intra-arterial
Peripheral arteriography
Adult: As 300 mg iodine/mL solution (61%): Femoral or subclavian artery: 5-40 mL. Aorta for a distal runoff: 25-50 mL. Max total: 250 mL. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intra-arterial
Selective visceral arteriography or aortography
Adult: As 370 mg iodine/mL solution (76%): Larger vessels e.g. aorta or coeliac artery: Up to 50 mL. Renal artery: Up to 10 mL. Max total: Up to 225 mL. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intrathecal
Computed tomographic cisternography
Adult: As 200 mg iodine/mL solution (41%): 4-6 mL via lumbar inj. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intrathecal
Myelography
Adult: Lumbar or thoracic: As 200 mg iodine/mL solution (41%): 10 to 15 mL. Cervical: As 200 mg iodine/mL solution (41%): 10-15 mL via lumbar inj or 10 mL via lateral cervical inj; As 300 mg iodine/mL solution (61%): 10 mL. Total columnar myelography: As 300 mg iodine/mL solution (61%): 10 mL. Doses are given via slow inj over 1-2 minutes. Dosage recommendations and route of administration may vary among countries or individual products. Refer to specific product guidelines.
Child: Lumbar or thoracic: As 200 mg iodine/mL solution (41%):  2-7 years 7-9 mL; 8-12 years 8-11 mL; 13-18 years 10-12 mL.

Intravenous
Excretory urography
Adult: As 250 mg iodine/mL solution (51%): 50-100 mL. As 300 mg iodine/mL solution (61%): 50 mL. As 370 mg iodine/mL solution (76%): 40 mL. Doses are administered via rapid inj. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Child: As 250 mg iodine/mL solution (51%): 1.2-3.6 mL/kg (Max: 120 mL). As 300 mg iodine/mL (61%): 1-3 mL/kg (Max: 100 mL). Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intravenous
Angiocardiography
Child: As 370 mg iodine/mL solution (76%). Single inj: <2 years 10-15 mL; 2-9 years 15-30 mL; 10-18 years 20-50 mL.  Cumulative inj: <2 years 40 mL; 2-4 years 50 mL; 5-9 years 100 mL; 10-18 years 125 mL. Doses may be administered via inj into a large peripheral vein or via direct cardiac catheterisation.

Intravenous
Computed tomography imaging
Adult: Head: As 250 mg iodine/mL solution (51%): 130-240 mL. As 300 mg iodine/mL solution (61%): 100-200 mL. Body: As 250 mg iodine/mL solution (51%): 130-240 mL. As 300 mg iodine/mL solution (61%): 100-200 mL. Doses are given via rapid infusion or bolus inj. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Child: Head and body: As 250 mg iodine/mL solution (51%): 1.2-3.6 mL/kg (Max: 120 mL). As 300 mg iodine/mL solution (61%): 1-3 mL/kg (Max: 100 mL). Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Intravenous
Peripheral venography
Adult: As 200 mg iodine/mL solution (41%): 25-150 mL per lower extremity. Max total for multiple inj: 350 mL. As 300 mg iodine/mL solution (61%): 15-100 mL per lower extremity. Max total for multiple inj: 230 mL. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Oral
Computed tomography imaging
Adult: Abdomen: As 61.24% solution: 100 mL of a 17% dilution, or up to 600 mL of a 3% dilution.

Oral
Diagnostic aid in the radiologic examination of the gastrointestinal tract
Adult: As 61.24% solution: 40-100 mL (undiluted).
Child: As 61.24% solution: 10-100 mL (undiluted), or 20-200 mL of up to a 50% dilution for infants.

Rectal
Diagnostic aid in the radiologic examination of the gastrointestinal tract
Adult: As 61.24% solution: 200 mL of a 50% dilution, or up to 1,000 mL of a 2% dilution.
Child: As 61.24% solution: 200 mL of 50-60% dilution.

Rectal
Computed tomography imaging
Adult: Pelvis: As 61.24% solution: 500-700 mL of a 3% dilution.
Contraindications
Intravascular: Known or suspected hypersensitivity to contrast media. Angiography in patients with homocystinuria. Intrathecal: Known or history of epilepsy. Myelography in the presence of significant local or systemic infection where bacteraemia is possible; immediate repeat myelography in the event of technical failure; concurrent intrathecal administration of corticosteroids. Concomitant use with drugs that may lower the seizure threshold.
Special Precautions
Patient with CV disease, diabetes, multiple myeloma or other paraproteinaemias, multiple sclerosis, hypercalcaemia, myasthenia gravis, phaeochromocytoma, sickle cell disease, thyroid disease, anuria, chronic alcoholism. Moderate to severe renal impairment, severe hepatic impairment or combined renal and hepatic impairment. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Acute kidney injury (e.g. renal failure), extravasation, seizures, electrolyte imbalance.
Cardiac disorders: Angina pectoris, bradycardia.
Gastrointestinal disorders: Nausea, vomiting.
General disorders and administration site conditions: Local tissue irritation, pain and swelling at inj site.
Musculoskeletal and connective tissue disorders: Back, leg or neck pain.
Nervous system disorders: Headache, dizziness.
Skin and subcutaneous tissue disorders: Hives.
Vascular disorders: Hot flushes, flushing, hypotension.
Potentially Fatal: Anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, acute generalised exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS); thromboembolic events which may lead to MI and stroke.
IT/IV/Parenteral: B
Monitoring Parameters
Monitor renal function; extravasation during IV administration; signs/symptoms of hypersensitivity during and for at least 30-60 minutes following procedure.
Drug Interactions
Risk of arterial thrombosis when given following papaverine. Vasopressors strongly potentiates the neurological effects of intra-arterial contrast media. Risk of renal toxicity in patients with hepatic impairment who were given oral cholecystographic agents followed by intravascular contrast agents. Risk of lactic acidosis with oral antidiabetic agents of the biguanide class. Increased risk of more severe anaphylactoid reactions with concomitant use of beta-blockers. Concomitant administration of interleukin-2 may result in atypical adverse reactions e.g. erythema, fever, flu symptom.
Potentially Fatal:Increased risk of seizures with drugs that may lower the seizure threshold (e.g. phenothiazine derivatives, TCAs, MAOIs, CNS stimulants, analeptics, antipsychotics).
Lab Interference
May interfere with thyroid function tests that depend on iodine estimation e.g. T3 resin uptake, total or free thyroxine (T4) assays. May also interfere with laboratory tests for bilirubin, proteins or inorganic substances (e.g. Fe, copper, Ca, phosphate).
Action
Description: Iopamidol is a nonionic iodinated radiographic contrast medium. It allows visualisation of internal body structures through opacification of vessels in the path of its flow.
Pharmacokinetics:
Absorption: Rapidly absorbed into the bloodstream from CSF after intravascular administration. Very poorly absorbed after oral or rectal administration.
Distribution: Distributed throughout the extracellular fluid but does not enter cells. Crosses the placenta. Volume of distribution: 0.28 L/kg.
Excretion: Intravascular: Mainly via urine (approx 50% as unchanged drug); faeces (approx 1%). Elimination half-life: Approx 2 hours.
Chemical Structure

Chemical Structure Image
Iopamidol

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 65492, Iopamidol. https://pubchem.ncbi.nlm.nih.gov/compound/Iopamidol. Accessed July 27, 2021.

Storage
Store between 20-25°C. Protect from light.
MIMS Class
Radiographic & Diagnostic Agents
ATC Classification
V08AB04 - iopamidol ; Belongs to the class of watersoluble, nephrotropic, low osmolar preparations used as X-ray contrast media.
References
Anon. Iopamidol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/03/2021.

Buckingham R (ed). Iopamidol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/03/2021.

Gastromiro (Bracco UK Ltd). MHRA. https://products.mhra.gov.uk. Accessed 29/03/2021.

Iopamiro (Bracco Imaging s.p.a.). MIMS Singapore. http://www.mims.com/singapore. Accessed 29/03/2021.

Isovue 250, 300 and 370 Injection, Solution (Bracco Diagnostics Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/03/2021.

Isovue-M Injection, Solution (Bracco Diagnostics Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 29/03/2021.

Scanlux 300 mg I/mL, Solution for Injection (Sanochemia Pharmazeutika GmbH). MHRA. https://products.mhra.gov.uk. Accessed 29/03/2021.

Scanlux 370 mg I/mL, Solution for Injection (Sanochemia Pharmazeutika AG). MHRA. https://products.mhra.gov.uk. Accessed 29/03/2021.

Disclaimer: This information is independently developed by MIMS based on Iopamidol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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