Yomeprol (Iomeprolum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Radiopaque means

Included in the formulation
  • Yomeron
    solution in / vessel. 
    Brakko Imajing SpA     Italy
    • АТХ:

    V.08.A.B   Water-soluble low-osmolarity radiopaque substances for the study of the kidneys

    Pharmacodynamics:Nonionic water-soluble nephrotropic iodine-containing low molecular weightth radiopaque a drug.
    Pharmacokinetics:

    The elimination half-life for ioemeprol in the distribution and elimination phases is 23 ± 14 minutes and 109 ± 20 minutes, respectively. Provided that the kidneys function normally, the total excretion of uterine kidney, expressed as a percentage of the intravenous dose, is approximately 24-34% after 60 minutes, 84% after 8 hours, 87% after 12 hours, and 95% 24-96 hours after administration. Thus, in patients with normal renal function (creatinine clearance more than 60 ml / min), the half-life of iomeprol is about 2 hours.

    In patients with impaired renal function, the half-life period is prolonged depending on the degree of kidney damage, depending on the creatinine clearance.

    Yomeprol does not bind to plasma proteins or blood serum.

    With intrathecal administration yomeprol Absorbed completely by cerebrospinal fluid for 3-6 hours. The half-life is 8-11 hours, depending on the dose. Yomeprol is excreted by the kidneys unchanged.Excretion in the urine almost completely occurs within 24 hours after administration, followed by the excretion of small amounts between 24 and 38 hours.

    Indications:Intravenous urography of adults and children, peripheral phlebography, computer tomography of the brain and spinal cord, whole body, cavernosography, intravenous digital subtraction angiography, angiocardiographyI adults and children, traditional selective coronary arteriography, interventional coronary arteriography, endoscopic retrograde cholangiopancreatography, arthrography, hysterosalpingographia, cholangiography, dacryocystographyI, sialografiya, retrograde urethrography, retrograde pyelourethrographyI, fistulography, myelography.
    ICD-10

    XXI.Z00-Z13.Z03   Medical surveillance and evaluation in case of suspected disease or pathological condition

    Contraindications:

    Hypersensitivity to the components of the drug; pregnancy; the period of breastfeeding; Waldenstrom's macroglobulinemia; severe hepatic, renal and cardiovascular insufficiency; multiple myeloma; severe thyrotoxicosis; atacute inflammatory diseases of the pelvic organs contraindicated hysterosalpingography; in acute pancreatitis, an endoscopic retrograde cholangiopancreatitisography.

    Carefully:Care should be taken when prescribing the drug to patients with impaired renal function, liver and cardiovascular systemthat system, pulmonary emphysema, a severe general condition, marked atherosclerosis, requiring correction of diabetes mellitus, latent hyperthyroidism, nodular goiter of mild and moderate severity.
    Pregnancy and lactation:Contraindicated in pregnancy and lactation.
    Dosing and Administration:The dose and method of application depend on the indications, the equipment used, the way the body is examined, the body weight, the state of hemodynamics, the general condition of the patient.
    Side effects:

    General types of reactions

    The most common headache, pain at the injection site, generalized feeling of heat, increased sweating, a sense of metallic taste in the mouth.

    Much less likely to be a feeling of discomfort or pain in the abdomen, nausea, vomiting.

    Hypersensitivity reactions

    Usually it can be such skin or respiratory reactions as various types of rash, erythema, urticaria, itching, pale skin; acute rhinitis, laryngeal edema, shortness of breath and a moderate decrease in blood pressure. These effects are usually short-lived.

    Very rarely there is dizziness, stiff neck, low back pain, temporary confusion. In some cases, fever occurs. Individual hypersensitivity is possible, especially in people with a predisposition to allergies, and also taking beta-blockers. In cases of hypersensitivity reactions, the administration of the contrast medium should be immediately stopped and, if necessary, an appropriate emergency intravenous therapy is performed.

    Severe cases of anaphylaxis involving the cardiovascular system are extremely rare and include the development of peripheral vasodilation with significant lowering of arterial pressure, reflex tachycardia, shortness of breath, agitation, cyanosis, loss of consciousness following a respiratory and / or heart attack, which can lead to death.Since these phenomena can develop very quickly, they require urgent cardiopulmonary resuscitation. Initially, cardiovascular collapse may occur, isolated or as an initial manifestation without respiratory or other symptoms listed above.

    From the cardiovascular system: peripheral vasodilation, marked decrease in blood pressure, tachycardia, shortness of breath, agitation, cyanosis and loss of consciousness (may require urgent treatment), transient bradycardia.

    From the nervous system: tonic / clonic convulsions, aphasia, syncope, temporary narrowing of the visual fields, hemiparesis, coma (developed in patients suffering from diseases of the central nervous system). In some cases, patients with increased convulsive readiness or using psychotropic drugs, with the introduction of the drug may occur spasms of skeletal muscles or generalized convulsions.

    Overdose:Overdose is unlikely in patients with normal renal function. In the case of high doses, the long-term effect of the drug on the kidneys is of great importance.There is no specific antidote, symptomatic treatment; it is possible to conduct hemodialysis.
    Interaction:

    The use of yomeprol in patients with diabetic nephropathy receiving metformin, can lead to a transient disruption of kidney function and the development of lactic acidosis. As a precaution, it is necessary to stop the use of metformin 48 hours before the study and resume after complete stabilization of kidney function.

    Simultaneous administration of io-meprola and glucocorticosteroids into the spinal canal can lead to the development of arachnoiditis.

    When used with psychotropic drugs, analgesics and antidepressants yomeprol can reduce the convulsive threshold.

    In patients taking beta-adrenoblockers, the manifestations of anaphylaxis in the use of io-meprol can be atypical and mistaken for vagal reactions.

    Special instructions:

    It is forbidden to mix radiopaque drug with other drugs in one syringe.

    When using the drug in patients who are to study the thyroid gland, it should be borne in mind that the absorption of iodine by thyroid tissues decreases for up to 2 weeks, which may affect the results of the study.

    Premises in which procedures are performed using radiocontrast preparations should be provided with equipment and medicines that are needed in emergency situations (oxygen cylinders, antihistamines and vasoconstrictors, glucocorticosteroid agents).

    With all modes of administration due to the possible development of serious side effects, the use of the drug should be limited in cases where there are no clear clinical indications for carrying out radiopaque studies. The need for the study should be determined taking into account the clinical state of the patient and the features of the course of possible diseases of the cardiovascular system, kidney and / or hepatobiliary system. Cardioangiography using radiopaque substances should be performed in hospitals and in hospitals. Special measures should be taken in patients with suspected thrombosis, phlebitis, severe ischemia, local infection, or arteriovenous obstruction.

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