Iopromide is a non-ionic, low-osmolar, monomeric, iodinated contrast medium used for intravascular and intrathecal radiographic imaging. It provides excellent opacification of blood vessels and body cavities with a favorable safety profile due to its low osmolality (approx. 0.590 osmol/kg H2O at 370 mg I/ml) and non-ionic nature, reducing the risk of chemotoxic and hyperosmolar reactions compared to older ionic agents.
Adult: Dose varies by procedure, patient weight, and imaging equipment. General IV guidelines: CT Body: 80-150 ml (approx. 1-2 ml/kg). CT Angiography: 70-120 ml. Angiography: Varies by vessel (e.g., cerebral: 5-10 ml/injection; coronary: 5-8 ml/injection). Urography: 50-100 ml. Maximum single dose should not exceed the recommended limits.
Note: For intravascular use only. Must be at body temperature before injection. Inspect visually for particulate matter and discoloration. Use aseptic technique. Administer via power injector or manual syringe. Flush line with normal saline. For intrathecal use (myelography), specific low-endotoxic formulations and strict aseptic lumbar puncture technique are mandatory.
Iopromide is a radiopaque contrast agent. Its efficacy is based on the physical property of iodine atoms (atomic number 53) to absorb X-rays, thereby creating a density difference between tissues/fluids containing the agent and surrounding structures. This enhances visualization of vascular structures, body cavities, and organ parenchyma during radiographic procedures like CT, angiography, and urography.
Pregnancy: Category B (US FDA). Iodinated contrast crosses the placenta. Use only if clearly needed, especially in the first trimester. The potential fetal risk from undiagnosed maternal condition may outweigh the theoretical risk. Fetal thyroid function should be monitored if used in later pregnancy.
Driving: Patients may experience dizziness or vasovagal reactions. Advise not to drive or operate machinery until fully recovered, typically for 12-24 hours post-procedure.
| Metformin | Increased risk of lactic acidosis if contrast-induced nephropathy occurs. Metformin must be stopped prior to the procedure and restarted only after 48 hours post-procedure upon confirmation of normal renal function. | High |
| Other Nephrotoxic Drugs (e.g., Aminoglycosides, NSAIDs, Amphotericin B, Cisplatin) | Additive risk of acute kidney injury. | High |
| Beta-blockers (especially non-selective) | May potentiate anaphylactoid reactions and make them harder to treat with epinephrine. | Moderate |
| Interleukin-2 (IL-2) | Increased risk of delayed adverse reactions. | Moderate |
| Diuretics (especially Loop Diuretics) | May worsen dehydration and increase risk of CIN. | Moderate |
| Thyroid Medications (for treatment of hyperthyroidism) | Iodine load can interfere with therapy and cause thyrotoxicosis recurrence. | High |
Same composition (Iopromide (370mg I/ml)), different brands: