Included in the formulation
АТХ:V.08.A Radiocontrast iodine-containing substances
Pharmacodynamics:Nonionic water-soluble radiocontrast with low osmolarity for urography and angiography.
Organic iodine compounds absorb X-rays and, selectively accumulating in separate structures of the body, provide a high degree of their opacity, highlighting them against the background of other structures that do not contain iodine. The degree of contrast is directly proportional to the concentration of the iodine-containing contrast agent in the tissue. After intravascular injection, the blood vessels are consistently contrasted, allowing visualization of their internal structure before the onset of significant hemodilution.
Pharmacokinetics:When intravenous and intra-arterial administration is distributed in the vascular system and interstitial space. It is excreted by the kidneys in the unmodified form by glomerular filtration (without reabsorption) or tubular secretion. In chronic renal failure, excretion is carried out through the biliary tract. It is excreted during hemodialysis.
Indications:250 mg iodine / ml: phlebography, computed tomography of the body, arteriography.
300 and 350 mg iodine / ml: intravenous urography, computed tomography of the skull and the whole body, phlebography, arteriography, angiocardiography.
XXI.Z00-Z13.Z03 Medical surveillance and evaluation in case of suspected disease or pathological condition
Contraindications:Conducting myelography, expressed thyrotoxicosis, increased sensitivity to yobitridol. Subarachnoidal administration.
Carefully:Use with caution in pregnancy and lactation, with hepatic and / or renal insufficiency, allergic diseases (bronchial asthma, eczema, urticaria, hay rhinitis, food and drug allergy), diabetes mellitus, myeloma, hyperuricemia, in juvenile screening children and elderly patients suffering from atherosclerosis.
Pregnancy and lactation:The category of recommendations is not defined. Adequate and well-controlled studies in animals and humans have not been carried out. In addition, any X-ray examination with irradiation of the abdominal cavity is not recommended because of the radiation load on the fetus. There is no information on the penetration into breast milk. It is recommended to temporarily stop breastfeeding after administration of iobitridol.
Possible application if the expected effect of the study exceeds the potential risk to the fetus (safety of use in pregnancy is not proven).
Dosing and Administration:Urography: with a slow intravenous injection - 1.2 ml / kg, the total volume - 50-100 ml, with a rapid intravenous injection - 1.6 ml / kg, total volume - 100 ml.
Computed tomography of the skull - 1.4 ml / kg, total volume - 20-100 ml; of the whole body - 1.9 ml / kg, the total volume - 20-150 ml.
Intravenous angiography - 1.7 ml / kg, the total volume - 40-270 ml.
Arteriography cerebral - 1.8 ml / kg, the total volume - 42-210 ml; arteriography of the lower extremities - 2.8 ml / kg, total volume - 85-300 ml.
Angiocardiography - 1.1 ml / kg, the total volume - 70-125 ml.
Side effects:Perhaps: a feeling of heat, nausea, vomiting, hyperemia of the skin; redness of the skin, isolated or combined disorders from the respiratory, nervous, digestive systems and cardiovascular systemthat system, collapse, shock, cardiac arrest is possible.
Overdose:Not described.
Treatment is symptomatic.
Interaction:Diuretics - against the background of dehydration caused by taking diuretics, the risk of developing acute kidney failure increases.
Biguanides - increased risk of lactic acidosis with concurrent use; biguanides should be canceled 2 days before the X-ray study and again appointed no earlier than 2 days later.
Special instructions:Diagnostic procedures should be performed under the supervision of personnel with experience in their conduct. It is necessary to have constant access to the venous bed for emergency treatment of possible complications, equipment for resuscitation and emergency therapy.
Patients with hyperuricemia, renal insufficiency, diabetes mellitus, myeloma, in young children and in elderly patients with atherosclerosis are encouraged to maintain a copious diuresis.
Patients with the greatest risk of developing unwanted reactions (in the presence of allergic diseases) are advisable to conduct premedication.
Nonionic radiopaque agents slow down the coagulation to a lesser extent in vitro in comparison with ionic ones, however, cases of platelet aggregation have been described when blood is in contact with a syringe containing a nonionic radiopaque agent, which may subsequently lead to the development of a myocardial infarction or stroke if a formed clot of blood enters the systemic circulation.Minimization of the risk of platelet aggregation during the procedure is facilitated by the fastest procedure, the use of plastic, rather than glass syringes and washing of catheters with heparinized 0.9% sodium chloride solution.