Home > Diatrizoic Acid (60%) > Diatrizoate Meglumine and Diatrizoate Sodium Injection

Diatrizoate Meglumine and Diatrizoate Sodium Injection

Diatrizoic Acid (60%)
Price: ₹300 - ₹600 per 50 mL vial (Approximate MRP)
Mfr: Various Generic Manufacturers (e.g., Troikaa, Jagsonpal) | Form: Injection Solution

📋 Clinical Overview

Diatrizoic Acid (60%) is a high-osmolality, ionic, iodinated contrast medium used for radiographic imaging. It is a tri-iodinated benzoic acid derivative that provides opacification of blood vessels and body cavities during X-ray, CT, and fluoroscopic procedures. In the Indian context, it is a widely used, cost-effective contrast agent for various diagnostic studies, though newer low-osmolality agents are preferred in high-risk patients.

💊 Dosage & Administration

  • Adult: Dose varies by procedure. Typical examples: IV Urography: 50-100 mL (approx. 0.5-1 mL/kg) IV bolus. CECT Abdomen: 75-150 mL IV. Angiography: Volume depends on vascular territory (e.g., 20-40 mL per injection for aortic studies).
  • Pediatric: Use with extreme caution. Dose is typically 1-3 mL/kg body weight, not to exceed a total of 3 mL/kg or 50 mL, whichever is lower. Must be calculated by a pediatric radiologist.
  • Renal Adjusment: CONTRAINDICATED in anuric patients. In renal impairment (eGFR 30-60), use only if absolutely necessary, ensure adequate hydration, consider alternative (low-osmolar) agent. Dose reduction may be considered. Monitor renal function post-procedure.
  • Hepatic Adjusment: No specific dosage adjustment, but use with caution in severe hepatic failure due to altered hemodynamics and potential for hepatorenal syndrome.
  • Instruction: For IV use: Administer as a bolus injection or via power injector for CT. Ensure patient is well-hydrated. Use strict aseptic technique. Do not mix with other drugs in syringe or infusion line. For intra-cavitary use (e.g., HSG): Instill slowly under fluoroscopic guidance. Pre-medication with antihistamines or corticosteroids may be considered for high-risk patients.

⚠️ Contraindications

  • Known hypersensitivity (anaphylaxis) to diatrizoate salts or any iodide
  • Patients with manifest hyperthyroidism or toxic thyroid adenoma
  • Intrathecal administration (can cause fatal neurotoxicity)
  • Myelography
  • Administration into the tracheobronchial tree (for bronchography)

🔬 Mechanism of Action

Diatrizoic Acid absorbs X-rays more effectively than surrounding body tissues due to its high iodine content (approximately 282 mg I/mL). This differential absorption creates a contrast between the lumen of vessels/body cavities and adjacent soft tissues, allowing for visualization on radiographic images. Its ionic nature in solution creates a high osmolality, leading to transient hemodynamic and physiological effects.

🤕 Side Effects

  • Sensation of warmth/flushing (especially in head, neck, pelvis)
  • Metallic taste in mouth
  • Nausea, mild vomiting
  • Pain at injection site
  • Mild urticaria (hives)
  • Sneezing

🤰 Special Populations

Pregnancy: Category D (US FDA). Iodinated contrast crosses the placenta and can depress fetal thyroid function. Use only if the potential benefit justifies the potential risk to the fetus, especially after the first trimester. Fetal thyroid function should be monitored if used.
Lactation: Small amounts are excreted in breast milk. The American College of Radiology states that it is safe to continue breastfeeding. Some sources suggest interrupting breastfeeding for 24-48 hours as a precaution, but this is not universally recommended. Consultation with a radiologist and pediatrician is advised.
Alcohol: No direct interaction. However, chronic alcohol use with liver disease increases risk. Acute alcohol intoxication with dehydration is a risk factor for CIN.
Driving: The procedure (sedation, pain, vasovagal reaction) may impair the ability to drive or operate machinery. Patients should be advised not to drive until fully recovered, typically on the same day.

🔄 Drug Interactions

🔁 Alternatives to Diatrizoate Meglumine and Diatrizoate Sodium Injection

Same composition (Diatrizoic Acid (60%)), different brands:

Urografin 60% Triografin