Iohexol

Hypersensitivity. Manifest thyrotoxicosis. For 240 and 300 mg iodine/mL solution inj into body cavity indicated for hysterosalpingography: Known or suspected reproductive tract neoplasia, infection signs in any portion of the genital tract (including external genitalia), menstruation or when menstrual period is imminent, within 30 days after conisation or curettage, within 6 months following pregnancy termination. 9 and 12 mg iodine/mL oral solution (Ominipaque^®/Oraltag^®): parenteral use; 140 and 350 mg iodine/mL solution: intrathecal administration. Known or suspected pregnancy (for 240 and 300 mg iodine/mL solution inj into body cavity used for hysterosalpingography).

Patient with allergic diathesis, history of known allergies (e.g. bronchial asthma, drug or food allergies); CV disease (e.g. severe coronary heart disease, unstable angina pectoris, valvular disease, prior MI or coronary bypass), pulmonary hypertension, risk factors for nephrotoxicity (e.g. dehydration, diabetes mellitus, CHF, advanced vascular disease, multiple myeloma, hyperuricaemia, paraproteinaemia, concomitant nephrotoxic or diuretic medications), hyper- or hypothyroidism, known or suspected phaeochromocytoma, sickle cell disease; myasthenia gravis, history of epilepsy, acute cerebral infarction, acute intracranial bleeding, cerebral oedema, acute demyelinisation, diseases that cause blood-brain barrier disturbance, advanced cerebral atherosclerosis, previous stroke, frequent TIA, alcohol or drug dependence. Ensure proper needle or catheter placement prior to and during infusion; avoid extravasation. Renal and hepatic impairment. Children and elderly. Pregnancy (except for preparations used in hysterosalpingography); lactation. Patient Counselling Ensure adequate hydration before and following administration. Monitoring Parameters Closely monitor for signs and symptoms of hypersensitivity and CV reactions. Monitor blood pressure specifically in patients with phaeochromocytoma or catecholamine-secreting paragangliomas.

Significant: Severe cutaneous adverse reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms); hypertensive crisis, acute kidney injury, including renal failure; thyroid storm, hyperthyroidism, transient thyroid suppression or hypothyroidism; exacerbation of myasthenia gravis, seizures, encephalopathy; transient hearing loss (following myelography). Rarely, local pain, oedema, erythema or tissue necrosis (if extravasation occurs). Cardiac disorders: Arrhythmias. Eye disorders: Visual disturbances, including photomas. Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain; lower abdominal pain (hysterosalpingography); pancreatitis (ERCP). General disorders and administration site conditions: Feeling hot; pain (arthrography). Investigations: Transient respiratory rate changes (intra-arterial/IV); increased blood amylase (ERCP). Musculoskeletal and connective tissue disorders: Back pain, neck pain or stiffness, lower limb cramp. Nervous system disorders: Headache, neuralgia, dizziness. Respiratory, thoracic and mediastinal disorders: Respiratory distress (intra-arterial/IV).
Potentially Fatal: Hypersensitivity reactions, including anaphylaxis. Rarely, CV reactions (e.g. hypotension, shock, cardiac arrest), thromboembolic events resulting in MI or stroke.

May lead to transient renal impairment and precipitate lactic acidosis in diabetics who are taking metformin. Increased risk of delayed reactions (e.g. flu-like symptoms, skin reactions, erythema) with interferons and interleukin-2 (<2 weeks treatment). Increased risk of contrast medium-induced seizures with agents that lower seizure threshold (e.g. phenothiazine derivatives, TCAs, certain neuroleptics). May lower the threshold for bronchospasm in asthmatic patients and reduce the responsiveness of treatment with epinephrine when given with β-blockers.

Miscellaneous

V08AB02 - iohexol ; Belongs to the class of watersoluble, nephrotropic, low osmolar preparations used as X-ray contrast media.