Radiopaque Agents

Intra-arterial: Ioxilan 300 mgI/mL is indicated for cerebral arteriography. Ioxilan 350 mgI/mL is indicated for coronary arteriography and left ventriculography, visceral angiography, aortography, and peripheral arteriography

Intravenous: Both products are indicated for excretory urography and contrast enhanced computed tomographic (CECT) imaging of the head and body

B

Ioxilan injection is not indicated for intrathecal use

Clotting has been reported when blood remains in contact with syringes containing ioxilan; use of plastic syringes in place of glass syringes has been reported to decrease, but not eliminate, the likelihood of in vitro clotting. Serious, rarely fatal, thromboembolic events causing myocardial infarction and stroke have been reported during angiographic procedures with both ionic and nonionic contrast media. Therefore, meticulous intravascular administration technique is necessary; caution must be exercised in patients with severely impaired renal function, combined renal and hepatic disease, combined renal and cardiac disease, severe thyrotoxicosis, myelomatosis, or anuria, particularly when large doses are administered.

1% to 10%:

Cardiovascular: Angina (1.3%), hypertension (1.1%)

Central nervous system: Headache (3.6%), fever (1.7%)

Gastrointestinal: Nausea (1.5%)

<1%: Bradycardia (0.8%), hypotension (0.9%), dizziness (0.8%), chills (0.6%), urticaria (0.8%), rash (0.6%), vomiting (0.9%), diarrhea (0.9%), injection site hematomas (0.8%)

Increased toxicity: Renal toxicity has been reported in a few patients with liver dysfunction who were given an oral cholecystographic agent followed by intravascular contrast agents such as ioxilan

Ioxilan is a nonionic, water soluble, tri-iodinated x-ray contrast agent for intravascular injection. Intravascular injection of a radiopaque diagnostic agent opacifies those vessels in the path of flow of the contrast medium, permitting radiographic visualization of the internal structures of the human body until significant hemodilution occurs.

Intra-arterial: Coronary arteriography and left ventriculography: For visualization of coronary arteries and left ventricle, ioxilan injection with a concentration of 350 mg iodine/mL is recommended

Usual injection volumes:

Left and right coronary: 2-10 mL (0.7-3.5 g iodine)

Left ventricle: 25-50 mL (8.75-17.5 g iodine)

Total doses should not exceed 250 mL; the injection rate of ioxilan should approximate the flow rate in the vessel injected

Cerebral arteriography: For evaluation of arterial lesions of the brain, a concentration of 300 mg iodine/mL is indicated

Recommended doses: 8-12 mL (2.4-3.6 g iodine)

Total dose should not exceed 150 mL

Prior to and 24-48 hours after intravascular administration: Thyroid function tests, renal function tests, blood counts, serum electrolytes, and urinalysis should be monitored for and blood pressure, heart rate, electrocardiogram, and temperature should be monitored throughout the procedure

The results of protein-bound iodine and radioactive iodine uptake studies, which depend on iodine estimations, will not accurately reflect thyroid function for at least 16 days following administration of iodinated contrast media. However, thyroid function tests that do not depend on iodine estimations (eg, T₃ resin uptake and total or free thyroxine (T₄) assays), are not affected.

Patients receiving iodinated intravascular contrast agents should be instructed to:

Inform physician if diabetic or have multiple myeloma, pheochromocytoma, homozygous sickle cell disease, or known thyroid disorder

Inform physician if allergic to any drugs or food, or have immune, autoimmune, or immune deficiency disorders; also inform physician if previous reactions to injections of dyes used for x-ray procedures

Inform physician about all medications currently being taken, including nonprescription (over-the-counter) drugs, before having this procedure

Patients receiving contrast agents, and especially those who are medically unstable, must be closely supervised. Diagnostic procedures that involve the use of iodinated intravascular contrast agents should be carried out under the direction of personnel skilled and experienced in the particular procedure to be performed. A fully equipped emergency cart, or equivalent supplies and equipment, and personnel competent in recognizing and treating adverse reactions of all types should always be available. Since severe delayed reactions have been known to occur, emergency facilities and competent personnel should be available for at least 30-60 minutes after administration.

Solution for injection: 300 mgI/mL (Oxilan® 300), 350 mgI/mL (Oxilan® 350)