Iohexol: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Injection
Aortography and selective visceral arteriography

Adult: Use 300 or 350 mg iodine/ml solution, single inj. Aorta: 50-80 ml; major branches: 30-60 ml; renal arteries: 5-15 ml. Repeat as necessary. Max: 300 mg iodine/ml: 291 ml; 350 mg iodine/ml: 250 ml.
Child: Use 350 mg iodine/ml solution: 1 ml/kg, single dose. Max: 5 ml/kg up to 250 ml.

Injection
Angiocardiography

Adult: Ventriculography: 350 mg iodine/ml: 30-60 ml, usual: 40 ml, may be repeated as necessary. If with selective coronary arteriography: max 250 ml. Selective coronary arteriography: 350 mg iodine/ml: 3-14 ml per inj, usual: 5 ml. Aortic root and arch study when used alone: 350 mg iodine/ml: 20-75 ml, usual 50 ml. Multiple procedures: 350 mg iodine/ml: max 250 ml.
Child: Ventriculography: 350 mg iodine/ml: 1-1.5 ml/kg, usual: 1.25 ml/kg; 300 mg iodine/ml: 1.5-2 ml/kg, usual 1.75 ml/kg. Max: 5 ml/kg; 350 mg iodine/ml: 250 ml; 300 mg iodine/ml: 291 ml. Pulmonary angiography: 350 mg iodine/ml: 1 ml/kg. Multiple procedures: Max: 5 ml/kg; 350 mg iodine/ml: 250 ml; 300 mg iodine/ml: 291 ml.

Injection
Voiding cystourethrography

Adult: Use diluted solutions using sterile water for inj to concentrations of 50-100 mg iodine/ml. Usual volume: 50 mg iodine/ml solution: 50-600 ml; 100 mg iodine/ml: 50-300 ml.
Child: Children: Use diluted solutions using sterile water for inj to concentrations of 50-100 mg iodine/ml: 50-300 ml.

Injection
Hysterosalpingography

Adult: 240 mg iodine/ml: 15-20 ml; 300 mg iodine/ml: 15-20 ml.

Injection
Arthrography

Adult: Knee: 240 mg iodine/ml: 5-15 ml; 300 mg iodine/ml: 5-15 ml; 350 mg iodine/ml: 5-10 ml. Shoulder: 240 mg iodine/ml: 3 ml; 300 mg iodine/ml: 10 ml. Temporomandibular: 300 mg iodine/ml: 0.5-1 ml. Lower volumes are recommended for double-contrast examinations; higher volumes are recommended fro single-contrast examinations.

Injection
Herniography

Adult: 240 mg iodine/ml: 50 ml.

Injection
Excretory urography

Adult: Use 300 or 350 mg iodine/ml solution: 200-350 mg iodine/kg.
Child: Use 300 mg iodine/ml solution: 0.5-3 ml/kg, usual: 1-1.5 ml/kg; max: 3 ml/kg.

Injection
Endoscopic retrograde cholangiopancreatography (ERCP), Endoscopic retrograde pancreatography (ERP)

Adult: Use 240 mg iodine/ml: 10-50 ml.

Intra-arterial
Peripheral arteriography

Adult: Aortofemoral runoffs: 350 mg iodine/ml: 20-70 ml; 300 mg iodine/ml: 30-90 ml. Selective arteriograms (femoral/iliac): 350 mg iodine/ml: 10-30 ml; 300 mg iodine/ml: 10-60 ml. Venography (per leg): 240 mg iodine/ml: 20-150 ml; 300 mg iodine/ml: 40-100 ml.

Intra-arterial
Cerebral arteriography

Adult: Use 300 mg iodine/ml solution: Common carotid artery: 6-12 ml; internal carotid artery: 8-10 ml; external carotid artery: 6-9 ml; vertebral artery: 6-10 ml.

Intra-arterial
Digital subtraction angiography

Adult: Use 140 mg iodine/ml solution: Aorta: 20-45 ml at 8-20 ml/sec; carotid: 5-10 ml at 3-6 ml/sec; femoral: 9-20 ml at 3-6 ml/sec; vertebral: 4-10 ml at 2-8 ml/sec; renal: 6-12 ml at 3-6 ml/sec; other branches of the aorta (includes subclavian, axillary, innominate and iliac): 8-25 ml at 3-10 ml/sec.

Intrathecal
Contrast-enhanced computerised tomography

Adult: Lumbar (via lumbar inj): 180 mg iodine/ml: 10-17 ml; 240 mg iodine/ml: 7-12.5 ml. Thoracic (via lumbar or cervical inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 6-10 ml. Cervical (via lumbar inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml solution: 6-10 ml. Cervical (via C1-2 inj): 180 mg iodine/ml: 7-10 ml; 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 4-10 ml. Total columnar (via lumbar inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 6-10 ml.
Child: Use 180 mg iodine/ml solution. 0-<3 mth: 240 ml; 3-<36 mth: 4-8 ml; 3-<7 yr: 5-10 ml; 7-<13 yr: 5-12 ml; 13-18 yr: 6-15 ml.

Intravenous
Contrast-enhanced computerised tomography of the abdomen

Adult: In conjunction with dilute oral admin, use 300 mg iodine/ml solution: 100-150 ml. The oral dose is administered 20-40 min prior to IV dose and image acquisition.
Child: In conjunction with dilute oral admin, use 240 or 300 mg iodine/ml solution: 1-2 ml/kg; max 3 ml/kg. The oral dose is administered 30-60 min prior to IV dose and image acquisition.

Intravenous
Digital subtraction angiography

Adult: 350 mg iodine/ml: 30-50 ml, as a bolus at 7.5-30 ml/second using a pressure injector, usually for 3 or more inj; max: 250 ml.

Intravenous
Contrast-enhanced computerised tomography

Adult: Head imaging by inj: 300 mg iodine/ml: 70-150 ml; 350 mg iodine/ml: 80 ml. Head imaging by infusion: 240 mg iodine/ml: 120-250 ml. Body imaging by inj: 300 mg iodine/ml: 50-200 ml; 350 mg iodine/ml: 60-100 ml.
Child: Head imaging: 240 or 300 mg iodine/ml: 1-2 ml/kg. Max: 28 g iodine with 240 mg iodine/ml solution or 35 g iodine with 300 mg iodine/ml solution.

Oral
Gastrointestinal tract examination

Adult: Use 350 mg iodine/ml solution: 50-100 ml.
Child: <3 mth: 180 mg iodine/ml: 5-30 ml. 3 mth-3 yr: 180, 240 or 300 mg iodine/ml: up to 60 ml; 4-10 yr: 180, 240 or 300 mg iodine/ml: up to 80 ml; >10 yr: 180, 240 or 300 mg iodine/ml: up to 100 ml.

Oral
Contrast-enhanced computerised tomography of the abdomen

Adult: Solutions diluted to 6-9 mg iodine/ml solution: 500-1000 ml.
Child: Solutions diluted to 9-21 mg iodine/ml solution: 180-750 ml; given at once or over 30-45 min. Max: <3 mth: 5 g iodine; 3-18 yr: 10 g iodine.

Contraindications

Procedure-specific. Intrathecal: Myelography in significant local or systemic infection where bacteremia is likely; concurrent use with corticosteroids; repeat myelography in the event of technical failure (risk of overdosage). Hysterosalpingography: During menstrual period or when menstrual flow in imminent; presence of infection; pregnancy, 6 mth after termination of pregnancy or 30 days after conization or curettage.

Special Precautions

Asthma or a history of allergies (risk of anaphylactoid reactions is increased); compromised blood-brain barrier (severe neurotoxicity after intrathecal use); epilepsy and brain tumour (higher risk of convulsions); severe hepatic or renal impairment, diabetics with renal impairment, dehydration and others who may be at increased risk of renal failure; multiple myeloma (dehydration from use may cause precipitation of protein in the renal tubules, leading to anuria and fatal renal failure); severe hypertension; advanced cardiac disease; phaeochromocytoma; sickle-cell disease; hyperthyroidism; debilitated, severely ill, very old, or very young patients; occlusive vascular disease. Special care to ensure that 140 and 350 mg iodine/ml solutions are not given intrathecally. Adequate resuscitative facilities should be available when radiographic procedures are undertaken, and patients should be kept under observation for a suitable period after the procedure.

Adverse Reactions

Flushing or a sensation of heat; pain, extravasation, thrombophlebitis at the inj site; nausea, vomiting, headache, and dizziness; urticaria, pruritus, pallor, sweating, metallic taste, weakness, coughing, rhinitis, sneezing, lachrymation, visual disturbances; hypotension, tachycardia, bradycardia, transient ECG abnormalities, haemodynamic disturbances; dyspnoea, bronchospasm, angioedema, severe urticaria; convulsions, paraesthesia, paralysis; acute renal failure; thromboembolism, disseminated intravascular coagulation, thrombocytopenia; hyperthyroidism, thyroid storm thyrotoxicosis.
Potentially Fatal: Profound hypotension, pulmonary oedema, respiratory arrest, ventricular fibrillation, circulatory failure, cardiac arrest, coma.

Pregnancy Category (US FDA)

Intra-arterial/Intracavitary/IT/IV/Parenteral/PO/Rectal: B

Lab Interference

Thyroid function, blood coagulation and certain urine tests.

Action

Description: Iohexol is a nonionic water-soluble radiographic contrast medium. It allows visualisation of internal body structures by opacifying the path of its flow. It contains a high concentration of organically bound iodine (140-350 mg iodine/ml).
Pharmacokinetics:
Distribution: Binding of iohexol to human plasma proteins: About 1.5%.
Excretion: Via urine (90%, as unchanged drug); 121-150 minutes (elimination half-life).

Storage

Store at 20-25°C. Protect from light. Do not freeze.

MIMS Class

Radiographic & Diagnostic Agents

Disclaimer: This information is independently developed by MIMS based on Iohexol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com