Pamidol Special Precautions

Warnings: The use of organic iodine compounds may cause untoward side effects and manifestations of anaphylaxis. The symptoms include nausea, vomiting, widespread erythema, generalized heat sensation, headache, coryza or laryngeal edema, fever, sweating, asthenia, dizziness, pallor, dyspnea and moderate hypotension. Skin reactions may occur in the form of various types of rash of diffuse blister formation. More severe reactions involving the cardiovascular system such as peripheral vasodilation with pronounced hypotension, tachycardia, dyspnea, agitation, cynosis and loss of conciousness may require emergency treatment.
The use of organic iodine contrast media must be limited to cases for which the diagnostic procedure is definitely indicated as suggested by the patient's clinical status with special attention to existing pathology of the cardiovascular, urinary or hepatobiliary system. In particular, contrast media designed for cardioangiographic procedures should be used in hospitals or clinics equipped and staffed for intensive care in emergencies or other more common diagnostic procedures wherein iodinized contrast media is used, the public or private institutions where such procedures take place, should be supplied with all the emergency drugs to handle any accident: the Ambo balloon, oxygen bottles, antihistamines, vasopressor drugs, corticosteroids.
Do not mix any other drugs with contrast medium solutions: In patients scheduled for thyroid examination with a radioactive iodine tracer, iodine uptake in the thyroid gland will be reduced for several days (sometimes upto 2 weeks) after dosing with aniodinized contrast medium that is eliminated through the kidneys.
Neuroradiology: In the event of CSF blockade, remove as much of the administered contrast solution as possible. The use of organic iodine contrast media may be contraindicated for patients with a history of epilepsy. Also the presence of blood in the CSF contraindicates the use of Iopamiro: in such cases, the operator should carefully assess the need for the diagnostic procedure against possible risk to the patient. Patients receiving treatment with anticonvulsant drugs must continue such treatment before and after the procedure. Should a convulsive seizure develop during the examination, administer diazepam or sodium Phenobarbital intravenously. Neuroleptics must be absolutely avoided because they lower the seizure threshold. The same applies to analgesics, antiemetics, antihistamines and sedatives of the phenothiazine group. Whenever possible, treatment with such drugs should be discontinued at least 48 hours before administration of the contrast medium and not be resumed less than 12 hours after completion of the procedure. Clinical trials have shown that Iopamiro is readily tolerated by the vast majority to patients, both in general terms and, particularly, in terms of CNS tolerability.
Angiography: In patients undergoing angiocardiographic procedures special attention should be paid to the status of the right heart and pulmonary circulation. Right after insufficiency and pulmonary hypertension may precipitate bradycardia and systemic hypotension, when the organic iodine solution is injected. In paediatric roentgentology, one should proceed with great caution when injecting the contrast medium into the right heart chambers of cyanotic neonates with pulmonary hypertension and impaired cardiac function. In examinations 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 the injector pump to the brachiocephalic 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 arteriography Iopamidol may sometimes cause a painful reaction in the involved limb. A property of nonionic 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.
755.53 mg: This is usually not the case with the less concentrated solution Iopamidol 300.
Precautions: Keep Iopamidol solutions away from strong light. Sometimes crystallization of Iopamidol solutions may occur. The cause of this is a damaged of defective container and therefore the product shouldn't be used in this case. Even invisible damage caused to the container during storage or transit may result in contamination. Before using check visually and don't use if precipitates or particular matter observed or contents not clear and return for replacement. The bottle once opened must be used immediately. Any residue of contrast medium must be discarded. Iopamidol as other iodinated contrast media can react with metallic surfaces containing copper (e.g. brass), therefore the use of equipment in which the product comes into direct contact with such surfaces should be avoided.