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Diatrizoate Meglumine

Medically reviewed by Drugs.com. Last updated on Nov 6, 2020.

Pronunciation

(dye a tri ZOE ate MEG loo meen)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Urethral:

Cystografin: 30% (100 mL, 300 mL)

Cystografin-Dilute: 18% (300 mL)

Brand Names: U.S.

  • Cystografin
  • Cystografin-Dilute

Pharmacologic Category

  • Iodinated Contrast Media
  • Radiological/Contrast Media, Ionic (High Osmolality)

Pharmacology

Radiopaque contrast agent.

Use: Labeled Indications

Retrograde cystourethrography: Diagnostic agent for retrograde cystourethrography

Contraindications

Hypersensitivity to diatrizoate meglumine, salts of diatrizoic acid, or any component of the formulation

Dosing: Adult

Note: A low residue diet the day prior to procedure and a laxative the night before are recommended. A scout film is recommended prior to contrast administration.

Retrograde cystourethrography: Bladder instillation: 25 to 300 mL; dose depends on the patient’s age and the degree of bladder irritability; may use >300 mL if bladder capacity allows. Results are best when bladder is filled with contrast agent.

Dosing: Pediatric

Refer to adult dosing.

Reconstitution

Diatrizoate meglumine 18% (Cystografin-Dilute): This is a ready-to-use product.

Diatrizoate meglumine 30%: Use undiluted or may dilute by adding sterile water or sterile saline to the bottle prior to instillation as follows:

100 mL bottle: Add 25 mL, 50 mL, or 67 mL (sterile water or sterile saline) for a total volume of 125 mL, 150 mL, or 167 mL, respectively.

300 mL bottle: Add 50 mL (sterile water or sterile saline) for a total volume of 350 mL.

Administration

For bladder instillation only. Not for intravascular or IV use. After sterile catheterization, fill bladder to capacity using a sterile bladder administration set. Avoid using excessive pressure, rapid or acute bladder distention, and trauma. Bladder discomfort or reflux/spontaneous voiding generally indicate a full bladder.

Dietary Considerations

Some products contain sodium.

Storage

Store at 20°C to 25°C (68°F to 77°F). Protect from light. If diluting diatrizoate meglumine 30% with sterile water or sterile saline prior to administration, use immediately after dilution.

Drug Interactions

Aldesleukin: May enhance the potential for allergic or hypersensitivity reactions to Iodinated Contrast Agents. Monitor therapy

Sodium Iodide I131: Iodinated Contrast Agents may diminish the therapeutic effect of Sodium Iodide I131. Management: Discontinue iodinated contrast agents before sodium iodide I-131 administration, and avoid concurrent use. Stop water soluble agents 2 months before, and stop lipophilic agents 6 months before, sodium iodide I-131 administration. Avoid combination

Test Interactions

Urine specimen assay: Contrast agent instillation into the bladder may interfere with urine specimen assay; collect urine prior to or at least 2 days after contrast administration.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.

Endocrine & metabolic: Altered thyroid hormone levels (transient suppression), hypothyroidism

Hypersensitivity: Anaphylactoid reactions (risk if intravasation of drug occurs), hypersensitivity reaction (risk if intravasation of drug occurs; reactions reported include facial edema, glottis edema, respiratory distress, convulsions, shock)

<1%, postmarketing, and/or case reports: Thyroid dysfunction (underactive; premature infants and infants with underlying medical conditions are more vulnerable; FDA Safety Alert, 2015)

Warnings/Precautions

Concerns related to adverse effects:

• Allergic reactions: Severe sensitivity reactions may occur; reactions are more likely to occur in patients with a history (personal or family) of bronchial asthma, significant allergies, or prior reaction to contrast agents. A history of sensitivity to iodine or to other contrast agents is not an absolute contraindication, although extreme caution should be exercised.

• Hypothyroidism: Thyroid function tests indicative of hypothyroidism or transient thyroid suppression have been reported (uncommon) in adult and pediatric patients (including infants); some patients were treated for hypothyroidism.

Disease-related concerns:

• Urinary infection: Use with caution in patients with known active urinary tract infection.

Other warnings/precautions:

• Appropriate use: Intended for bladder instillation only; not for intravascular or IV administration. Safe and effective use depends on proper dosage, correct technique, adequate precautions, and preparation for potential emergencies. Use sterile technique for administration. Avoid excessive pressure, rapid or acute bladder distention, and trauma.

Monitoring Parameters

Monitor for signs/symptoms of hypersensitivity.

Pregnancy Considerations

Diatrizoate crosses the placenta (Dean 1977).

Iodinated contrast media agents may cross the placenta. Due to theoretical concerns that exposure to free iodide may adversely affect the fetus, use should be avoided unless absolutely required to obtain diagnostic information that will influence the care of the mother or fetus during pregnancy (ACOG 723 2017; ACR 2018).

Patient Education

What is this drug used for?

• It is used before an x-ray or an alike test.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Seizures

• Blood in the urine

• Bladder irritation

• Change in amount of urine passed

• Unable to pass urine

• Signs of an allergic reaction, like 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.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine’s uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.