Lipiodol Ultra-Fluide

Lipiodol Ultra-Fluide

Manufacturer:

Guerbet

Distributor:

Pacific Healthcare
Concise Prescribing Info
Contents
Ethyl esters of iodized fatty acids of poppy seed oil. Iodine content: 480 mg/mL
Indications/Uses
Diagnostic radiology: Lymphography, hysterosalpingography, sialography. Interventional radiology: Visualisation, localisation & vectorisation during trans-arterial chemo-embolisation (TACE) of hepatocellular carcinoma at intermediate stage, in adults.
Dosage/Direction for Use
Diagnostic radiology Lymphography: 5-7 mL via catheter inserted into strict lymphatic route, depending on the height of patient. Hysterosalpingography: 10-20 mL by slow inj into uterine cervical canal, depending on the vol of uterine cavity. Sialography: Not more than 5 mL until the salivary gland is filled. Administer by cannulation of salivary duct. Childn & low wt patients Dose must be reduced proportionally. Infants 1-2 yr 1 mL per extremity. Interventional radiology TACE of hepatocellular carcinoma: Administer by selective intra-arterial catheterism of the hepatic artery. Dose depends on the extent of lesion. Max total dose: 15 mL. Lipiodol Ultra Fluide can be mixed w/ anticancer drugs eg, cisplatin, doxorubicin, epirubicin & mitomycin.
Contraindications
Hypersensitivity to iodine-containing products or ethyl esters of iodised fatty acids of poppy seed oil. Acute pelvic inflammation. Confirmed hyperthyroidism or pulmonary insufficiency. Traumatic lesions, haemorrhage or recent bleeding (risk of extravasation or embolism). Bronchography. Pregnancy. Administration in liver areas w/ dilated bile ducts (specific for use in interventional radiology).
Special Precautions
Do not administer IV, intra-arterially (apart from selective catheterisation) or intrathecally. History of hypersensitivity. Patients w/ impaired resp function, cardiorespiratory failure or right ventricular overload, especially the elderly. Uncontrolled asthma. Latent hyperthyroidism or thyroid autonomy. Perform thyroid function test consequently prior to radiological exam. Decompensated liver cirrhosis (Child-Pugh ≥8), advanced liver dysfunction, macroscopic invasion &/or extra-hepatic spread of the tumour. Carefully monitor oesophageal varices. Perform endoscope sclerotherapy/ligature prior TACE procedure if risk of rupture is demonstrated. Maintain medical monitoring & an indwelling IV catheter during exam. Dehydrated patients, renal failure, diabetes, severe heart failure, monoclonal gammopathy (multiple myeloma, Waldenstrom's macroglobulinemia), history of renal failure after administration of iodinated contrast agents. Hydrate patients prior to & after exam. Concomitant use w/ nephrotoxic drugs eg, aminoglycosides, organoplatinums, high doses of methotrexate, pentamidine, foscarnet & certain antiviral agents (aciclovir, ganciclovir, valaciclovir, adefovir, cidoforvir, tenofovir), vancomycin, amphotericin B, immunosuppressors eg, cyclosporine or tacrolimus, ifosfamide. Allow at least 48 hr between radiological exam or interventions w/ iodinated contrast agents inj or delay further exam or interventions until renal function returns to baseline. Monitor serum creatinine in diabetics w/ metformin for lactic acidosis. Discontinue metformin before & for at least 48 hr after contrast agent administration or renal function returns to baseline. Assess CV &/or pulmonary co-morbidities prior to initiation of TACE procedure. Avoid any vascular penetration & do not inj into bleeding or trauma areas. Childn <1 yr. Elderly (atheromatous). Lactation (discontinue).
Adverse Reactions
Increase temp followed by a fever (38-39°C), fat microembolism. Post embolisation syndrome (fever, abdominal pain, nausea, vomiting) & transitory changes in liver function tests. Hypersensitivity, anaphylactic reaction; hyperthyroidism; cerebral embolism; pulmonary embolism; vomiting, diarrhoea, nausea; pain; fat embolism. Spinal cord injury.
Drug Interactions
Lactic acidosis induced by diminished renal function w/ metformin. Reduced efficacy of CV compensation mechanism for BP disorders w/ β-blockers, vasoactive substances, ACE inhibitors & angiotensin receptor antagonists. Increased risk of acute renal failure w/ diuretics. Increased reactions to contrast agents w/ interleukin 2.
ATC Classification
V08AD01 - ethyl esters of iodised fatty acids ; Belongs to the class of non-watersoluble preparations used as X-ray contrast media.
Presentation/Packing
Form
Lipiodol Ultra-Fluide 480 mgI/mL
Packing/Price
10 mL x 1's
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