Omnipaque 300mg/ml Inj, 100ml
Overview
What is this medicine?
How to Use This Medicine
To ensure safe and effective use of this medication, follow your doctor's instructions carefully. Read all the information provided to you and adhere to the instructions closely.
Preparation and Administration
Before receiving this medication, it is essential to be properly hydrated. Consult your doctor to determine if you need to drink extra fluids before administration. After taking this medication, drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
Administration Methods
Injection: Your doctor will administer this medication. You may receive other medications before this one to help prevent side effects.
Liquid: This medication can be taken orally or administered rectally.
Storage and Disposal
Liquid: If you need to store this medication at home, consult your doctor, nurse, or pharmacist for guidance on proper storage.
Injection: This medication will be administered in a healthcare setting, and you will not need to store it at home.
Missed Dose
Liquid: If you miss a dose, contact your doctor to determine the best course of action.
Injection: Since this medication is administered in a healthcare setting, you will not need to worry about missing a dose.
Lifestyle & Tips
- Drink plenty of fluids before and after the procedure, especially if you have kidney problems, to help flush the dye out of your body.
- Inform your doctor about all your medications, allergies (especially to iodine or previous contrast dyes), and medical conditions (especially kidney disease, diabetes, thyroid problems, or asthma) before the procedure.
- Follow any specific instructions given by your healthcare provider regarding fasting or medication adjustments before the procedure.
Available Forms & Alternatives
Available Strengths:
- Omnipaque 300mg/ml Inj, 30ml
- Omnipaque 240mg/ml Inj, 50ml
- Omnipaque 350mg/ml Inj, 50ml
- Omnipaque 240mg/ml Inj, 100ml
- Omnipaque 350mg/ml Inj, 500ml
- Omnipaque 300mg/ml Inj, 50ml
- Omnipaque 180mg/ml Inj, 10ml
- Omnipaque 350mg/ml Inj, 200ml
- Omnipaque 350mg/ml Inj, 150ml
- Omnipaque 350mg/ml Inj, 100ml
- Omnipaque 240mg/ml Inj, 20ml
- Omnipaque 240mg/ml Inj, 10ml
- Omnipaque 300mg/ml Inj, 150ml
- Omnipaque 300mg/ml Inj, 100ml
- Omnipaque 300mg/ml Inj, 500ml
- Omnipaque 300mg/ml Inj, 10ml
- Omnipaque 140mg/ml Inj, 50ml
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
Side Effects
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:
Allergic Reactions: Rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat. In rare cases, allergic reactions can be fatal.
Thyroid Problems: Changes in weight, feeling nervous, excitable, restless, or weak, hair thinning, depression, eye or neck swelling, difficulty focusing, trouble with heat or cold, menstrual changes, shakiness, or sweating.
Injection-Related Side Effects:
+ Chest pain or pressure, rapid heartbeat, or abnormal heartbeat.
+ Weakness on one side of the body, trouble speaking or thinking, changes in balance, drooping on one side of the face, or blurred vision.
+ Severe dizziness or fainting.
+ Shortness of breath, significant weight gain, or swelling in the arms or legs.
+ Swelling, warmth, numbness, color changes, or pain in a leg or arm.
+ Seizures.
+ Changes in vision.
Tissue Damage: If the medication leaks from the vein, it can cause tissue damage. Inform your nurse if you experience redness, burning, pain, swelling, blisters, skin sores, or fluid leakage at the injection site.
Severe Skin Reactions: These can occur anywhere from 1 hour to several weeks after receiving the medication and may include:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other serious reactions that can affect body organs and be life-threatening.
+ Symptoms may include: red, swollen, blistered, or peeling skin; red or irritated eyes; sores in the mouth, throat, nose, eyes, genitals, or skin; fever; chills; body aches; shortness of breath; or swollen glands. Seek medical help immediately if you experience any of these symptoms.
Injection into the Spine: A burning, numbness, or tingling sensation that is not normal.
Liquid Formulation: Swelling.
Other Possible Side Effects
Most people do not experience significant side effects, but some may occur. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical attention:
Common Side Effects:
+ Upset stomach or vomiting
+ Headache
Injection-Related Side Effects:
+ Dizziness (if given in an artery or vein)
+ Feeling of warmth
+ Changes in taste
+ Dizziness (if given into the spine)
+ Back pain
+ Neck pain
+ Stiff neck
Liquid Formulation:
+ Stomach pain or diarrhea
+ Gas
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Difficulty breathing, wheezing, or tightness in the chest
- Hives, rash, or severe itching
- Swelling of the face, lips, tongue, or throat
- Dizziness, lightheadedness, or fainting
- Severe pain, swelling, or redness at the injection site
- Unusual weakness or numbness
- Changes in vision
- Nausea or vomiting that is severe or persistent
Before Using This Medicine
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Allergies: If you are allergic to this medication, any of its components, or other substances, including foods or drugs. Describe your allergic reaction and the symptoms you experienced.
Dehydration or poor nutrition: If you are dehydrated, have been eating poorly, or have recently used a laxative or diuretic.
Previous skin reactions: If you have had a skin reaction to this medication or a similar drug in the past.
Metformin use: If you are currently taking metformin.
Additional Considerations for Specific Administration Routes:
Spinal injection: Inform your doctor if you have an active infection or are taking medications that may increase the risk of seizures, or if you have taken such a medication within the last 48 hours. There are many drugs that can increase seizure risk, so consult your doctor or pharmacist if you are unsure.
Injection into an artery or vein: Tell your doctor if you are unable to urinate.
Use before an x-ray of the uterus and fallopian tubes: Inform your doctor if you are menstruating, have a genital infection, or have a suspected growth in the reproductive tract. Also, notify your doctor if you have had a curettage or conization procedure within the past 30 days, or if you have had a pregnancy terminated within the last 6 months.
Pregnancy and This Medication:
Do not take this medication if you are pregnant or may be pregnant.
Interactions with Other Medications and Health Conditions:
This is not an exhaustive list of all potential interactions. It is crucial to inform your doctor and pharmacist about all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you may have.
Before starting, stopping, or changing the dose of any medication, consult your doctor to ensure it is safe to do so in combination with this medication.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Your doctor may need to monitor your blood work regularly. Additionally, this medication may affect the results of certain laboratory tests, so be sure to notify all your healthcare providers and lab personnel that you are taking this drug.
If you experience any signs of kidney problems, such as difficulty urinating, changes in urine output, bloody, brown, or foamy urine, shortness of breath, cough, or swelling in your face, feet, or hands, contact your doctor immediately.
Special Considerations
If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects. Similarly, if the patient is a child, this medication should be used with caution, as the risk of side effects may be higher in some children.
If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to discuss the potential benefits and risks to you and your baby.
Injection Administration
If this medication is administered via injection into an artery or vein, be aware of the following risks:
In children under 3 years of age, this medication has been associated with low thyroid function, which can impact child development. Your child's thyroid function may need to be monitored for an extended period after the injection.
Rarely, life-threatening or fatal heart problems, including low blood pressure and heart attack, have occurred with this medication. Discuss these risks with your doctor.
* When used in conjunction with certain procedures, this medication has been linked to health problems, such as blood clots, which can increase the risk of heart attack and stroke. If you have questions or concerns, consult your doctor.
If this medication is administered via injection into the spine, be aware that it may increase the risk of seizures, particularly in individuals with a history of seizures. Consult your doctor to determine if you are at a higher risk of seizures while taking this medication.
Overdose Information
Overdose Symptoms:
- Fluid overload (pulmonary edema)
- Electrolyte disturbances
- Acute renal failure
- Cardiovascular collapse
- Seizures
What to Do:
Treatment is symptomatic and supportive. Monitor vital signs, fluid and electrolyte balance. Hemodialysis can be used to remove Iohexol from the body in cases of severe overdose or renal failure. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Major Interactions
- Metformin (in patients with renal impairment or acute kidney injury risk)
- Interleukin-2 (increased risk of delayed reactions)
Moderate Interactions
- Beta-blockers (increased risk of anaphylactoid reactions, blunted response to epinephrine)
- Diuretics (increased risk of dehydration and CIN)
- Nephrotoxic drugs (e.g., NSAIDs, aminoglycosides, cisplatin) - increased risk of CIN
Monitoring
Baseline Monitoring
Rationale: To assess baseline kidney function and risk of contrast-induced nephropathy (CIN).
Timing: Prior to contrast administration (within 48 hours for high-risk patients, or up to 30 days for low-risk patients).
Rationale: To identify patients at increased risk of hypersensitivity reactions.
Timing: Prior to contrast administration.
Rationale: Iodine can affect thyroid function, especially in patients with pre-existing thyroid disease.
Timing: Consider in patients with known or suspected thyroid dysfunction.
Rationale: Dehydration increases the risk of CIN.
Timing: Prior to contrast administration.
Routine Monitoring
Frequency: Before, during, and immediately after injection, then as clinically indicated.
Target: Within patient's normal range
Action Threshold: Significant deviations (e.g., hypotension, bradycardia, respiratory distress) require immediate intervention.
Frequency: Continuously during and for at least 30 minutes post-injection.
Target: Absence of symptoms
Action Threshold: Rash, urticaria, dyspnea, angioedema, hypotension, bronchospasm.
Frequency: During and immediately after injection.
Target: Absence of swelling, pain, redness
Action Threshold: Pain, swelling, redness, or blistering at injection site.
Frequency: 48-72 hours post-contrast in high-risk patients (e.g., pre-existing renal impairment, diabetes, dehydration).
Target: Stable or improving
Action Threshold: Increase in serum creatinine by âĨ0.3 mg/dL or âĨ50% from baseline within 48-72 hours.
Symptom Monitoring
- Hives
- Itching
- Rash
- Swelling of face/lips/tongue/throat
- Difficulty breathing or wheezing
- Dizziness or lightheadedness
- Nausea
- Vomiting
- Headache
- Flushing
- Metallic taste
- Injection site pain or swelling
- Chest pain
- Seizures
- Changes in vision
Special Patient Groups
Pregnancy
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Animal studies have shown no evidence of harm, but human data are limited. Category B.
Trimester-Specific Risks:
Lactation
Considered safe for use during breastfeeding. Iohexol is minimally excreted into breast milk and poorly absorbed by the infant's gastrointestinal tract. Infant exposure is very low. No need to interrupt breastfeeding.
Pediatric Use
Dosing is weight-based and procedure-specific. Children, especially neonates and infants, are more susceptible to fluid shifts and temperature changes. Careful attention to hydration and dose calculation is essential. Risk of contrast-induced nephropathy is generally lower than in adults but still a concern in vulnerable populations.
Geriatric Use
Increased risk of contrast-induced nephropathy due to age-related decline in renal function, comorbidities (e.g., diabetes, heart failure), and polypharmacy. Careful assessment of renal function and hydration status is crucial. Use the lowest effective dose.
Clinical Information
Clinical Pearls
- Always ensure adequate hydration before and after contrast administration, especially in patients at risk for CIN.
- Carefully review patient history for allergies, renal impairment, diabetes, and thyroid disease prior to administration.
- Have emergency equipment and medications (e.g., epinephrine, antihistamines, corticosteroids) readily available for immediate treatment of hypersensitivity reactions.
- Non-ionic contrast agents like Iohexol have a lower incidence of adverse reactions compared to older ionic agents.
- Extravasation can occur; monitor injection site closely. If extravasation occurs, elevate the limb, apply cold compresses, and monitor for skin integrity changes.
Alternative Therapies
- Iopamidol (Isovue)
- Iodixanol (Visipaque)
- Ioversol (Optiray)
- Gadolinium-based contrast agents (for MRI, different mechanism)
- Barium sulfate (for GI tract imaging, different mechanism)
Cost & Coverage
General Drug Facts
Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Properly dispose of unused or expired medications. Unless instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs, which can be an alternative disposal option.
Some medications may come with an additional patient information leaflet. If you have questions or concerns about your medication, it is crucial to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the quantity, and the time it was taken, as this will aid in prompt and effective treatment.