Iopromide is a non-ionic, low-osmolar, monomeric iodinated contrast medium used for intravascular and intrathecal radiographic imaging. It contains 300 mg of organically bound iodine per milliliter. Its low osmolality (approximately 590 mOsm/kg water at 37°C for the 300 mg I/ml concentration) reduces the risk of adverse hemodynamic and pain reactions compared to older ionic agents. It is widely used in computed tomography (CT), angiography, and urography in the Indian healthcare setting.
Adult: Dose depends on type of examination, patient weight, and imaging equipment. General IV guidelines: CT Body: 50-150 ml (15-45 g I); Angiography: Varies by vessel (e.g., cerebral: 5-10 ml per injection, aortic: 20-50 ml). Maximum single dose should not exceed the lowest dose necessary for adequate imaging.
Note: For intravascular use: Administer as a bolus injection or controlled infusion using a power injector. Use strict aseptic technique. Pre-warming to body temperature reduces viscosity. For intrathecal use (myelography): MUST use only the specific formulation approved for intrathecal administration. Administer via lumbar puncture after dilution with CSF. Patient must remain in semi-upright position. Do not mix with other drugs or solutions.
Iopromide is a radiopaque contrast agent. It contains iodine atoms (which have a high atomic number) that effectively absorb X-rays. When injected into blood vessels, body cavities, or the subarachnoid space, it attenuates X-rays passing through the body, creating a contrast between the fluid-filled spaces (e.g., blood vessels, renal collecting system, cerebrospinal fluid) and surrounding tissues on radiographic images.
Pregnancy: Category B (US FDA). Iodinated contrast media cross the human placenta and enter the fetal circulation. Use only if clearly needed and after careful risk-benefit assessment, especially during first trimester. Potential risk of neonatal hypothyroidism exists but is considered very low with single exposure.
Driving: Patients should be advised not to drive or operate machinery for several hours after the procedure, especially if they received sedatives, experienced a vasovagal reaction, or underwent myelography.
| Metformin | Risk of lactic acidosis if contrast-induced nephropathy occurs. Must be withheld before and after procedure as per protocol. | High |
| Interleukin-2 | Increased risk of delayed hypersensitivity reactions to contrast media. | Moderate |
| Beta-blockers | May mask tachycardia as an early sign of anaphylaxis and may impair response to epinephrine. | Moderate |
| NSAIDs (e.g., Ibuprofen) | May increase risk of contrast-induced nephropathy, especially in pre-existing renal impairment. | Moderate |
| Diuretics (e.g., Furosemide) | May potentiate dehydration and increase risk of nephrotoxicity. | Moderate |
| Other Nephrotoxic drugs (Aminoglycosides, Amphotericin B) | Additive risk of acute kidney injury. | High |