Drug Guide

Generic Name

Iohexol

Brand Names Omnipaque 70, Omnipaque 140, Omnipaque 180, Omnipaque 210, Omnipaque 240, Omnipaque 300, Omnipaque 350, Omnipaque 9, Omnipaque 12, Oraltag

Classification

Therapeutic: Contrast media

Pharmacological: Non-ionic, water-soluble iodinated radiographic contrast agent

FDA Approved Indications

Imaging of blood vessels and organs to detect abnormalities (angiography, CT angiography)
Myelography
Venography, urography, cholangiography, arthrography
CT imaging of various organs

Mechanism of Action

Iohexol enhances contrast by increasing the attenuation of X-rays in the structures where it accumulates, thereby improving visualization during radiologic examinations.

Dosage and Administration

Adult: Dosage varies based on procedure; typically 50-150 mL administered intravenously, with adjustments based on patient size and specific imaging requirements.

Pediatric: Dosing varies by weight and indication; consult specific protocols.

Geriatric: Use with caution; assess renal function before administration.

Renal Impairment: Adjust dose or avoid if renal function is severely impaired; risk of contrast-induced nephropathy.

Hepatic Impairment: No specific adjustments typically required.

Pharmacokinetics

Absorption: Not absorbed from the gastrointestinal tract when given orally; used IV for imaging.

Distribution: Distributes within the extracellular fluid compartment.

Metabolism: Not metabolized; remains unchanged.

Excretion: Primarily excreted unchanged via the kidneys.

Half Life: Approximately 2 hours in patients with normal renal function.

Contraindications

Hypersensitivity to iodinated contrast media
Severe renal impairment without adequate hydration

Precautions

Assess renal function prior to administration.
Hydrate patients before and after administration to reduce risk of nephropathy.
Use caution in patients with asthma or allergies to iodine.

Adverse Reactions - Common

Warm sensation or flushing (Common)
Metallic taste (Common)
Nausea or vomiting (Less common)

Adverse Reactions - Serious

Anaphylactic reactions (Rare)
Nephropathy (contrast-induced) (Rare in at-risk populations)

Drug-Drug Interactions

Other nephrotoxic agents (aminoglycosides, NSAIDs)
Thiazide diuretics

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess allergy history, renal function, and hydration status.

Diagnoses:

Risk for renal impaired function
Risk for allergic reaction

Implementation: Ensure adequate hydration, monitor vital signs, and observe for adverse reactions during and after procedure.

Evaluation: Monitor renal function post-procedure, observe for allergic reactions.

Patient/Family Teaching

Report any history of allergies to contrast agents or iodine.
Inform that a warm sensation or metallic taste may occur during administration.
Maintain hydration before and after the procedure.

Special Considerations

Black Box Warnings:

Use carefully in patients with allergies to iodine or prior contrast reactions.
Monitor renal function closely in at-risk patients.

Genetic Factors: No specific genetic factors identified.

Lab Test Interference: May interfere with certain blood tests; ensure laboratory staff are aware of contrast administration.

Overdose Management

Signs/Symptoms: Signs of overdose may include signs of allergic reactions, nephrotoxicity, or volume overload.

Treatment: Supportive care, symptomatic treatment, hydration, and in severe cases, corticosteroids or antihistamines for allergic reactions.

Storage and Handling

Storage: Store at controlled room temperature, 20-25°C (68-77°F).

Stability: Stable until expiration date printed on the vial.