Iopamidol

Oral
As a 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.

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.

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.

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
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
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.

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
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.

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.

Rectal
As a 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.

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.

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. Monitoring Parameters Monitor renal function; extravasation during IV administration; signs/symptoms of hypersensitivity during and for at least 30-60 minutes following procedure.

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.

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).

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).

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.
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.

Intra-arterial: Store between 20-25°C. Protect from light. Intrathecal: Store between 20-25°C. Protect from light. Intravenous: Store between 20-25°C. Protect from light. Oral: Store between 20-25°C. Protect from light. Rectal: Store between 20-25°C. Protect from light.

Miscellaneous

V08AB04 - iopamidol ; Belongs to the class of watersoluble, nephrotropic, low osmolar preparations used as X-ray contrast media.