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iodixanol

Generic Name: iodixanol (eye oh DIX an ol)
Brand Name: Visipaque, Visipaque RediFlo Cartridge

What is iodixanol?

Iodixanol is in a group of drugs called radiopaque (RAY dee oh payk) contrast agents. Iodixanol contains iodine, a substance that absorbs x-rays. Radiopaque contrast agents are used to allow blood vessels, organs, and other non-bony tissues to be seen more clearly on a CT scan or other radiologic (x-ray) examination.

Iodixanol is used to help diagnose certain disorders of the brain, blood vessels, and kidneys.

Iodixanol may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about iodixanol?

Tell your doctor if you have asthma, hay fever, or a history of food or drug allergies, especially if you have had any type of reaction to another contrast agent.

Drink extra fluids before and after you receive iodixanol. This medication can cause you to get dehydrated, which can lead to dangerous effects on your kidneys. Follow your doctor's instructions about the types and amount of fluids you should drink before and after your test.

Older adults may need special care in avoiding dehydration by drinking extra fluids before and after the radiologic test. Your kidney function may also need to be watched closely after you have received iodixanol.

Iodixanol should not be given to a child who has recently used a laxative (stool softener) or has not eaten properly before the test. You should not receive iodixanol if you have any type of active infection.

What should I discuss with my health care provider before receiving iodixanol?

Tell your doctor if you have ever had any type of reaction to another contrast agent.

Iodixanol should not be given to a child who has recently used a laxative (stool softener) or has not eaten properly before the test. You should not receive iodixanol if you have any type of active infection.

Before receiving iodixanol, tell your doctor if you have:

  • a brain tumor or hematoma;

  • a recent head or brain injury;

  • epilepsy or other seizure disorder;

  • kidney disease;

  • liver disease;

  • heart disease, including congestive heart failure;

  • sickle cell anemia;

  • a history of stroke, blood clots, or circulation problems;

  • asthma, hay fever, or a history of food or drug allergies;

  • diabetes;

  • a weak immune system caused by disease or by taking certain medicines such as steroids or cancer treatment;

  • an autoimmune disorder such as lupus, multiple sclerosis, or rheumatoid arthritis;

  • multiple myeloma (bone cancer);

  • pheochromocytoma;

  • a thyroid disorder.

If you have any of these conditions, you may not be able to receive iodixanol, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether iodixanol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may need special care in avoiding dehydration by drinking extra fluids before and after the radiologic test. Your kidney function may also need to be watched closely after you have received iodixanol.

How is iodixanol used?

Iodixanol is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting, just before your radiologic test.

Drink extra fluids before and after you receive iodixanol. This medication can cause you to get dehydrated, which can lead to dangerous effects on your kidneys. Follow your doctor's instructions about the types and amount of fluids you should drink before and after your test.

What happens if I miss a dose?

Since iodixanol is used only during your radiologic test, you will not be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. Symptoms of an iodixanol overdose may include difficulty breathing, fast or pounding heartbeats, and seizure (convulsions).

What should I avoid while receiving iodixanol?

Do not allow yourself to become dehydrated during the first few days after receiving iodixanol. Call your doctor if you have any vomiting or diarrhea during this time. Follow your doctor's instructions about the types and amount of fluids you should drink.

Iodixanol side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • urinating less than usual or not at all;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • seizure (convulsions);

  • feeling light-headed, fainting;

  • swelling in your hands, ankles, or feet;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • wheezing or trouble breathing; or

  • fever, chills, body aches, flu symptoms.

Other less serious side effects are more likely to occur, such as:

  • headache, dizziness, nervousness;

  • nausea, vomiting;

  • pain, warmth, or cold feeling where the medicine was injected;

  • numbness, warmth, or tingly feeling;

  • unusual or unpleasant taste in your mouth;

  • skin redness or itching; or

  • sleep problems (insomnia).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Iodixanol dosing information

Usual Adult Dose for Intra-arterial Digital Subtraction Angiography:

Iodixanol 270 mgI/mL or 320 mgI/mL is recommended for intra-arterial injection for intra-arterial digital subtraction angiography.

Carotid Arteries: 5 to 8 mL (320 mgI/mL)
Vertebral Arteries: 5 to 8 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 175 mL

Renal Arteries: 10 to 25 mL (270 mgI/mL)
Aortography: 20 to 50 mL (270 mgI/mL), 10 to 50 mL (320 mgI/mL)
Major Branches of Aorta: 5 to 30 mL (270 mgI/mL), 2 to 10 mL (320 mgI/mL)
Aortofemoral Runoffs: 6 to 15 mL (320 mgI/mL)
Peripheral Arteries: 3 to 15 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Adult Dose for Computed Tomography:

Intravenous administration of iodixanol injection (270 mgI/mL or 320 mgI/mL) is recommended for Contrast Enhanced Computed Tomography (CECT).

CECT of Head:
Bolus Infusion:
75 to 150 mL (270 mgI/ mL)
75 to 150 mL (320 mgI/ mL)
Maximum Total Volume: 150 mL

CECT of Body:
Bolus Infusion:
100 to 150 mL (270 mgI/ mL)
100 to 150 mL (320 mgI/ mL)
Maximum Total Volume: 150 mL

Usual Adult Dose for Urography:

Intravenous administration of iodixanol injection (270 mgI/mL or 320 mgI/mL) is recommended.

Excretory Urography:
Normal Renal Function:
1 mL/kg (270 mgI/ mL)
1 mL/kg (320 mgI/ mL)
Maximum Total Volume: 100 mL

Usual Adult Dose for Venography:

Intravenous administration of iodixanol injection (270 mgI/mL) is recommended.

Venography:
Per Lower Extremity:
50 to 100 mL (270 mgI/ mL)
Maximum Total Volume: 250 mL

Usual Adult Dose for Peripheral Arteriography:

Intra-arterial Administration:

Peripheral Arteries: 15 to 30 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Adult Dose for Cerebral Arteriography:

Intra-arterial Administration:

Carotid Arteries: 10 to 14 mL (320 mgI/mL)
Vertebral Arteries: 10 to 12 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 175 mL

Usual Adult Dose for Coronary Arteriography:

Intra-arterial Administration:

Right Coronary Artery 3 to 8 mL (320 mgI/mL)
Left Coronary Artery 3 to 10 mL (320 mgI/mL)
Left Ventricle 20 to 45 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 200 mL

Usual Adult Dose for Aortography:

Intra-arterial Administration:

Aortography: 30 to 70 mL (320 mgI/mL)
Major Branches of Aorta: 10 to 70 mL (320 mgI/mL)
Aortofemoral Runoffs: 20 to 90 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Adult Dose for Renal Arteriography:

Intra-arterial Administration:

Renal Arteries 8 to 18 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Pediatric Dose for Cerebral Arteriography:

Intra-arterial Administration:

Greater than 1 to 12 years of age:

1 to 2 mL/kg (320 mgI/mL)
The total dose should not exceed 4 mL/kg.

Greater than 12 years of age:

Carotid Arteries: 10 to 14 mL (320 mgI/mL)
Vertebral Arteries: 10 to 12 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 175 mL

Usual Pediatric Dose for Intra-arterial Digital Subtraction Angiography:

Iodixanol 270 mgI/mL or 320 mgI/mL is recommended for intra-arterial injection for intra-arterial digital subtraction angiography.

Greater than 12 years of age:

Carotid Arteries: 5 to 8 mL (320 mgI/mL)
Vertebral Arteries: 5 to 8 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 175 mL

Renal Arteries: 10 to 25 mL (270 mgI/mL)
Aortography: 20 to 50 mL (270 mgI/mL), 10 to 50 mL (320 mgI/mL)
Major Branches of Aorta: 5 to 30 mL (270 mgI/mL), 2 to 10 mL (320 mgI/mL)
Aortofemoral Runoffs: 6 to 15 mL (320 mgI/mL)
Peripheral Arteries: 3 to 15 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Pediatric Dose for Coronary Arteriography:

Intra-arterial Administration:

Greater than 1 to 12 years of age:

1 to 2 mL/kg (320 mgI/mL)
The total dose should not exceed 4 mL/kg.

Greater than 12 years of age:

Right Coronary Artery 3 to 8 mL (320 mgI/mL)
Left Coronary Artery 3 to 10 mL (320 mgI/mL)
Left Ventricle 20 to 45 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 200 mL

Usual Pediatric Dose for Renal Arteriography:

Intra-arterial Administration:

Greater than 12 years of age:

Renal Arteries 8 to 18 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Pediatric Dose for Aortography:

Intra-arterial Administration:

Greater than 1 to 12 years of age:

1 to 2 mL/kg (320 mgI/mL)
The total dose should not exceed 4 mL/kg.

Greater than 12 years of age:

Aortography: 30 to 70 mL (320 mgI/mL)
Major Branches of Aorta: 10 to 70 mL (320 mgI/mL)
Aortofemoral Runoffs: 20 to 90 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Pediatric Dose for Peripheral Arteriography:

Intra-arterial Administration:

Greater than 12 years of age:

Peripheral Arteries: 15 to 30 mL (320 mgI/mL)
Max Total Dose: Usually not to exceed 250 mL

Usual Pediatric Dose for Computed Tomography:

Intravenous administration of iodixanol injection (270 mgI/mL or 320 mgI/mL) is recommended for Contrast Enhanced Computed Tomography (CECT).

Greater than 1 to 12 years of age:

1 to 2 mL/kg (270 mgI/mL)
The total dose should not exceed 2 mL/kg.

Greater than 12 years of age:

CECT of Head:
Bolus Infusion:
75 to 150 mL (270 mgI/ mL)
75 to 150 mL (320 mgI/ mL)
Maximum Total Volume: 150 mL

CECT of Body:
Bolus Infusion:
100 to 150 mL (270 mgI/ mL)
100 to 150 mL (320 mgI/ mL)
Maximum Total Volume: 150 mL

Usual Pediatric Dose for Urography:

Intravenous administration of iodixanol injection (270 mgI/mL or 320 mgI/mL) is recommended.

Greater than 1 to 12 years of age:

1 to 2 mL/kg (270 mgI/mL)
The total dose should not exceed 2 mL/kg.

Greater than 12 years of age:

Excretory Urography:
Normal Renal Function:
1 mL/kg (270 mgI/ mL)
1 mL/kg (320 mgI/ mL)
Maximum Total Volume: 100 mL

Usual Pediatric Dose for Venography:

Intravenous administration of iodixanol injection (270 mgI/mL) is recommended.

Greater than 12 years of age:

Venography:
Per Lower Extremity:
50 to 100 mL (270 mgI/ mL)
Maximum Total Volume: 250 mL

What other drugs will affect iodixanol?

There may be other drugs that can affect iodixanol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist has more information about iodixanol written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.04. Revision Date: 2010-12-15, 5:01:39 PM.

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