Pamidol Side Effects

The use of Iopamidol as a contrast medium for cerebral angiography may cause side effects which are usually mild and of short duration. Many patients report a sensation of heat in the face and neck; a few complain of headache. A fairly frequent cardiovascular reaction to dosing with Iopamidol is bradycardia associated with systemic hypotension.
The reaction is transient and requires no treatment. Severe neurological sequelae may arise as direct complications of preexisting pathology in the individual patient. Such reactions are diverse and may include tonic/clonic convulsions, aphasia, fainting, and transient narrowing of visual field, hemiparesis and coma. The risk associated with a particular investigation involved may be increased by conditions such as advanced arteriosclerosis, hypertension, heart failure, major systemic diseases and recent cerebral embolism or thrombosis.
In patients undergoing angiographic procedures special attention should be paid to the status of the right heart and pulmonary circulation. Right heart insufficiency and pulmonary hypertension may precipitate bradycardia and systemic hypotension, when the organic iodine solution is injected. In examination of the aortic arch, the tip of the catheter should be positioned carefully to avoid hypotension, bradycardia and CNS injury due to excess pressure transmitted from injector pump to the branchiocephalic branches of the aorta. Likewise in abdominal aortography, excess pressure from the pump may cause renal infarction, spinal cord injury, retroperitoneal bleeding, intestinal infarction and necrosis.
In peripheral Iopamidol may sometimes cause a painful reaction in the involved limb. This usually not the case with the less concentrated solution Iopamidol. A property of noninonic contrast media have less anticoagulant activity in-vitro than ionic media. Medical personnel performing vascular catheterization procedures should be aware of this and pay meticulous attention to the angiographic technique and catheter flushing so as to minimize the risk of procedure related thrombosis and embolism.