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acetrizoic acid

V08AA07

Forms & Strengths

Powder for solution for injection, 300 mg I/mL (300 mg iodine per mL)
Contains 2.5% acetrizoic acid and 0.3% sodium metabisulfite as preservative
High‑osmolar ionic contrast medium
Sterile, non‑pyrogenic vial

Adult Dosing

IV bolus 30–150 mL for cerebral angiography (300 mg I/mL)
IV bolus 50–100 mL for coronary angiography
IV/IA 15–30 mL for myelography
Maximum total dose 150 mL per examination
Reduce dose 30‑50% in severe renal impairment

Pediatric Dosing

0.5–1.0 mL/kg IV, not exceeding 100 mL total
30–60 mL for children >2 kg undergoing angiography
Adjust dose downward in renal dysfunction
Avoid in neonates if alternative exists

Indications

X‑ray cerebral, carotid and peripheral angiography
Coronary angiography and cardiac catheterization
Intravenous urography (IVP)
Myelography
Peripheral vascular imaging

Mechanism of Action

Iodine atoms absorb X‑ray photons, increasing radiodensity
High‑osmolar ionic, water‑soluble contrast medium that displaces water in vascular and interstitial spaces

Contraindications

Known hypersensitivity to iodinated contrast media
Severe renal insufficiency (eGFR <30 mL/min/1.73 m²)
Uncontrolled hyperthyroidism or thyroid storm
Pregnancy (potential fetal iodine overload)
History of severe anaphylactoid reaction to contrast

Adverse Reactions

Warmth, flushing, metallic taste
Nausea, vomiting, headache
Urticaria, pruritus, angioedema
Anaphylactoid shock, bronchospasm
Contrast‑induced nephropathy

Drug Interactions

Metformin – hold before and after contrast to prevent lactic acidosis
Nephrotoxic agents (aminoglycosides, NSAIDs) – increase risk of renal injury
ACE inhibitors/ARBs – may exacerbate contrast nephropathy
Iodinated drugs (amiodarone, iodine‑containing radiopharmaceuticals) – increase thyroid dysfunction risk
Beta‑blockers – may mask tachycardia in anaphylaxis

Curated Content: Needs Vetting Before Put to Clinical Use