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iopromide

V08AB05

Forms & Strengths

Injectable solution, 300 mg I/mL (0.3 g I/mL)
Available in single‑use vials: 1.5 mL, 2 mL, 5 mL, 10 mL, 20 mL
Non‑ionic, low‑osmolality iodinated contrast

Adult Dosing

CT/angiography: 0.5–2.0 mL/kg (≈150–300 mg I/kg), typical 1.0–1.5 mL/kg
Urography: 0.5–1.0 mL/kg
Maximum single dose ≈200 mL (≈60 g iodine)
Renal impairment: use lowest effective dose, consider 0.3 mL/kg
Inject as bolus 1–3 mL/sec followed by saline flush

Pediatric Dosing

Children ≥1 yr: 0.5–2.0 mL/kg (max 2 mL/kg)
Neonates/infants: 0.3–0.5 mL/kg
Maximum total volume 20 mL (≈6 g iodine)
Adjust dose for renal dysfunction; avoid high dose in severe renal impairment

Indications

Contrast‑enhanced CT of head, neck, chest, abdomen, pelvis
CT angiography (cerebral, coronary, peripheral)
CT urography and intravenous urography
Digital subtraction angiography, venography, arteriography
Myelography and arthrography

Mechanism of Action

Iodine’s high atomic number absorbs X‑rays, increasing radiodensity of vessels/tissues
Non‑ionic, low‑osmolality formulation reduces endothelial disruption and discomfort

Contraindications

Known hypersensitivity to iopromide or any iodinated contrast agent
Prior severe anaphylactoid reaction to iodinated contrast
Uncontrolled hyperthyroidism or thyrotoxic crisis
Severe renal insufficiency (eGFR <30 mL/min/1.73 m²) when alternative imaging is available
Pregnancy only if essential; avoid in breastfeeding when possible

Adverse Reactions

Immediate: nausea, vomiting, warm sensation, metallic taste, urticaria, pruritus, bronchospasm, hypotension, anaphylaxis
Delayed: maculopapular rash, fever
Contrast‑induced nephropathy (rise in serum creatinine 24‑72 h)
Iodine‑induced thyroid dysfunction (hyper‑ or hypothyroidism)
Headache, injection‑site pain

Drug Interactions

Metformin: hold before/after contrast in renal impairment to prevent lactic acidosis
NSAIDs, ACE‑I/ARBs, diuretics: increase risk of contrast‑induced nephropathy; consider temporary discontinuation
Iodinated contrast interferes with radioactive iodine therapy and thyroid function tests
Beta‑blockers may exacerbate anaphylactoid reactions
Concurrent nephrotoxic antibiotics (e.g., aminoglycosides) may potentiate renal injury

Curated Content: Needs Vetting Before Put to Clinical Use