Omnipaque 350mg/ml Inj, 50ml
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 guidelines.
Preparation and Administration
Before receiving this medication, it is essential to be well-hydrated. Consult your doctor to determine if you need to drink additional fluids before administration. After taking this medication, consume 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
- Stay well-hydrated before and after the procedure, especially if you have kidney problems or diabetes. Your doctor or nurse will give you specific instructions.
- Inform your healthcare provider about all your medications, allergies, and medical conditions, especially kidney disease, diabetes, thyroid problems, or asthma.
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, seek medical attention right away:
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, fast heartbeat, or abnormal heartbeat.
+ Weakness on one side of the body, trouble speaking or thinking, change 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, change in color, 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), and other serious reactions. Seek medical help immediately if you experience:
+ Red, swollen, blistered, or peeling skin.
+ Red or irritated eyes.
+ Sores in your mouth, throat, nose, eyes, genitals, or any areas of skin.
+ Fever.
+ Chills.
+ Body aches.
+ Shortness of breath.
+ Swollen glands.
Spinal injection side effects: A burning, numbness, or tingling sensation that is not normal.
Liquid formulation side effects: 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:
Common side effects:
+ Upset stomach or vomiting.
+ Headache.
Injection-related side effects (if given in an artery or vein):
+ Dizziness.
+ Feeling of warmth.
+ Change in taste.
Spinal injection side effects:
+ Dizziness.
+ Back pain.
+ Neck pain.
+ Stiff neck.
* Liquid formulation side effects:
+ Stomach pain or diarrhea.
+ Gas.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult 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
- Severe rash, hives, or itching
- Swelling of the face, lips, tongue, or throat
- Dizziness, lightheadedness, or feeling faint
- Sudden severe pain, swelling, or redness at the injection site
- Decreased urination or swelling in your legs/feet (signs of kidney problems)
Before Using This Medicine
It is essential to inform your doctor about the following conditions to ensure safe use of this medication:
Any allergies you have, including allergies to this drug, its components, or other substances, such as foods or medications. Describe the allergic reaction and its symptoms.
If you are dehydrated, have been experiencing poor nutrition, or have recently used a laxative or diuretic.
If you have had a previous skin reaction to this medication or a similar drug.
If you are currently taking metformin.
Additional Considerations for Specific Administration Routes:
Injection into the spine: 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 numerous medications 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 known or 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 conditions you have.
Before starting, stopping, or changing the dose of any medication, consult your doctor to ensure it is safe to do so in conjunction 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, and this medication may affect certain lab tests. Be sure to notify all your healthcare providers and lab workers 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 or older, use this medication with caution, as you may be more susceptible to side effects. Similarly, if the patient is a child, use this medication with caution, as the risk of side effects may be higher in some children.
If you are pregnant, plan to become pregnant, or are breastfeeding, consult your doctor to discuss the benefits and risks of this medication to you and your baby.
Injection (Given in an Artery or Vein)
In children under 3 years of age, the use of medications like this one has been associated with low thyroid function, which can impact child development. If the patient is a child, your doctor may need to monitor their thyroid function for a period after the injection. If you have questions or concerns, discuss them with your doctor.
Rarely, life-threatening or fatal heart problems, including low blood pressure and heart attack, have occurred with this medication. Additionally, health problems like blood clots have been reported when this medication is used in conjunction with certain procedures, which can increase the risk of heart attack and stroke. If you have questions, consult your doctor.
Injection (Given into the Spine)
This medication may increase the risk of seizures in some individuals, particularly those 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, heart failure)
- Electrolyte disturbances
- Acute renal failure
- Severe hypersensitivity reactions
What to Do:
Treatment is symptomatic and supportive. Monitor vital signs, fluid and electrolyte balance, and renal function. 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 risk factors for lactic acidosis)
- Interleukin-2 (IL-2) (increased risk of delayed adverse reactions)
Moderate Interactions
- Beta-blockers (may exacerbate anaphylactoid reactions and make them more resistant to epinephrine)
- Nephrotoxic drugs (e.g., NSAIDs, aminoglycosides, cisplatin) (increased risk of contrast-induced acute kidney injury)
- Oral cholecystographic agents (may interfere with visualization)
Monitoring
Baseline Monitoring
Rationale: To assess baseline kidney function and risk of contrast-induced acute kidney injury (CI-AKI).
Timing: Prior to administration, especially in patients with risk factors (e.g., pre-existing renal impairment, diabetes, heart failure, age >65).
Rationale: To identify patients at increased risk for hypersensitivity reactions to iodinated contrast media.
Timing: Prior to administration.
Rationale: Adequate hydration is crucial for preventing CI-AKI.
Timing: Prior to administration.
Routine Monitoring
Frequency: Before, during, and immediately after administration, then as clinically indicated.
Target: Within patient's normal range.
Action Threshold: Significant deviations (e.g., hypotension, bradycardia, tachycardia, desaturation) warrant immediate intervention.
Frequency: Continuously during and for a period after administration (e.g., 30-60 minutes).
Target: Absence of symptoms.
Action Threshold: Rash, urticaria, pruritus, angioedema, bronchospasm, hypotension, laryngeal edema.
Frequency: 24-72 hours post-procedure in at-risk patients.
Target: Stable or returning to baseline.
Action Threshold: Increase in serum creatinine by âĨ0.3 mg/dL or âĨ50% from baseline within 48-72 hours.
Symptom Monitoring
- Rash
- Hives (urticaria)
- Itching (pruritus)
- Swelling (angioedema, especially face, lips, tongue, throat)
- Difficulty breathing (dyspnea, bronchospasm)
- Wheezing
- Cough
- Dizziness or lightheadedness
- Nausea
- Vomiting
- Headache
- Flushing
- Chest pain or discomfort
- Signs of extravasation (pain, swelling, redness at injection site)
- Decreased urine output (sign of kidney injury)
Special Patient Groups
Pregnancy
Iohexol crosses the placenta. Animal studies have shown no evidence of harm to the fetus. Human data are limited but do not suggest an increased risk of major birth defects or miscarriage. Use during pregnancy should only occur if clearly needed and the potential benefit outweighs the potential risk to the fetus.
Trimester-Specific Risks:
Lactation
Iohexol is excreted into breast milk in small amounts. Due to its poor oral absorption, it is not expected to cause adverse effects in breastfed infants. Breastfeeding can generally be continued without interruption after iohexol administration. If concerns exist, a temporary interruption (e.g., 6-24 hours) and discarding milk can be considered, but is usually not necessary.
Pediatric Use
Dosing is weight-based and highly individualized. Careful attention to hydration is critical to prevent dehydration and contrast-induced acute kidney injury, especially in neonates and infants. Lower concentrations may be preferred for certain procedures. Risk of thyroid dysfunction in neonates/infants, especially premature, should be considered.
Geriatric Use
Increased risk of pre-existing renal impairment, dehydration, and cardiovascular disease, which predispose to contrast-induced acute kidney injury and other adverse reactions. Careful assessment of renal function and hydration status is essential. Use lowest effective dose.
Clinical Information
Clinical Pearls
- Always assess renal function (eGFR) before administering iohexol, especially in at-risk patients (e.g., diabetes, pre-existing kidney disease, heart failure, elderly).
- Ensure adequate hydration before and after the procedure to minimize the risk of contrast-induced acute kidney injury (CI-AKI).
- Patients on metformin should have the drug held before and for 48 hours after contrast administration if there is any risk of renal impairment, and renal function re-evaluated before restarting metformin.
- Be prepared to manage hypersensitivity reactions, ranging from mild urticaria to severe anaphylaxis. Have resuscitation equipment and medications (e.g., epinephrine, antihistamines, corticosteroids) readily available.
- Extravasation can occur; monitor the injection site closely. If extravasation occurs, elevate the limb, apply cold compresses, and monitor for skin integrity changes.
- For intrathecal use (myelography), ensure the correct concentration is used, as higher concentrations can cause neurotoxicity (e.g., seizures).
Alternative Therapies
- Other non-ionic iodinated contrast media (e.g., Ioversol, Iopamidol, Iodixanol)
- Ionic iodinated contrast media (less commonly used due to higher osmolality and adverse reaction rates)
- Gadolinium-based contrast agents (for MRI, different mechanism, different risks)
- Non-contrast imaging modalities (e.g., ultrasound, non-contrast CT, non-contrast MRI) where appropriate.
Cost & Coverage
General Drug Facts
To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion.
Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so. If you are unsure about the best method for disposing of your medication, consult your pharmacist for guidance. Many communities have drug take-back programs that provide a safe and environmentally friendly way to dispose of unused medications.
Some medications may come with an additional patient information leaflet. Check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken, as this will help healthcare professionals provide the most effective treatment.