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Ultravist
iopromide
Black Box Warnings .
Not for Intrathecal Use
inadvertent intrathecal administration may cause death, convulsions, cerebral hemorrhages, coma, paralysis, arachnoiditis, acute renal failure, cardiac arrest, seizures, rhabdomyolysis, hyperthermia, and brain edema; not approved for intrathecal use
Adult Dosing .
Dosage forms: INJ: 300 mg per mL, 370 mg per mL
Special Note
- [strength clarification]
- Info: strength expressed as iodine concentration
angiocardiography
- [coronary artery]
- Dose: 3-14 mL (370 mg per mL) intra-arterially x1; Max: 225 mL/total dose
- [left ventricle]
- Dose: 30-60 mL (370 mg per mL) intra-arterially x1; Max: 225 mL/total dose
aortography
- [individualize dose (370 mg per mL) intra-arterially x1]
- Max: 225 mL/total dose
cerebral arteriography
- [carotid arteries]
- Dose: 3-12 mL (300 mg per mL) intra-arterially x1; Max: 150 mL/total dose
- [vertebral arteries]
- Dose: 4-12 mL (300 mg per mL) intra-arterially x1; Max: 150 mL/total dose
- [aortic arch]
- Dose: 20-50 mL (300 mg per mL) intra-arterially x1; Max: 150 mL/total dose
peripheral arteriography
- [subclavian or femoral artery]
- Dose: 5-40 mL (300 mg per mL) intra-arterially x1; Max: 250 mL/total dose
- [aortic bifurcation]
- Dose: 25-50 mL (300 mg per mL) intra-arterially x1; Max: 250 mL/total dose
visceral angiography
- [individualize dose (370 mg per mL) intra-arterially x1]
- Max: 225 mL/total dose
computed tomography, head or body
- [50-200 mL (300 mg per mL) IV x1]
- Max: 200 mL/total dose; Alt: 41-162 mL (370 mg per mL) IV x1, max 162 mL/total dose
excretory urography
- [1 mL/kg/dose (300 mg per mL) IV x1]
- Max: 100 mL/total dose
mammography adjunct
- [1.5 mL/kg/dose (300 mg per mL or 370 mg per mL) IV x1]
- Max: 150 mL/total dose
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised in hepatorenal disease
Peds Dosing .
- Dosage forms: INJ: 300 mg per mL, 370 mg per mL
Special Note
- [strength clarification]
- Info: strength expressed as iodine concentration
radiography, cardiac chambers and related arteries
- [>2 yo]
- Dose: 1-2 mL/kg/dose (370 mg per mL) intra-arterially x1; Max: 4 mL/kg/total dose
computed tomography, head or body
- [>2 yo]
- Dose: 1-2 mL/kg/dose (300 mg per mL) IV x1; Max: 3 mL/kg/total dose up to 200 mL
excretory urography
- [>2 yo]
- Dose: 1-2 mL/kg/dose (300 mg per mL) IV x1; Max: 3 mL/kg/total dose up to 100 mL
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Contraindications / Cautions .
- intrathecal use
- symptomatic hyperthyroidism
- homocystinuria (angiocardiography use)
- hypersensitivity to drug or ingredient
- caution: hypersensitivity to other iodinated contrast media
- caution: patients <3 yo
- caution: asthma
- caution: allergies, known
- caution: renal impairment
- caution: renal impairment risk
- caution: arterial disease, severe
- caution: venous disease, severe
- caution: hyperthyroidism
- caution: autonomously functioning thyroid nodule
- caution: cardiovascular disease
- caution: CHF
- caution: hepatorenal disease
- caution: cardiorenal disease
- caution: congenital cardiac conditions (peds patients)
- caution: thromboembolism risk (angiography use)
- caution: pheochromocytoma
- caution: myasthenia gravis
Drug Interactions .
Overview
iopromide
contrast agent
- nephrotoxicity
- thrombogenic effects
- avoid combo with radioactive iodine; iopromide may decrease thyroid uptake of radioactive iodine, efficacy for at least 6wk
Contraindicated
- cidofovir
Avoid/Use Alternative
- aldesleukin
- amikacin
- amikacin inhaled
- amiloride
- bumetanide
- chlorothiazide
- chlorthalidone
- clofarabine
- ethacrynic acid
- foscarnet
- furosemide
- ganciclovir
- gentamicin
- hydrochlorothiazide
- indapamide
- iodixanol
- iohexol
- iomeprol
- iopamidol
- iopromide
- iothalamate meglumine
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- mannitol
- methotrexate
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- oxaliplatin
- pentamidine
- polyethylene glycol
- polyethylene glycol/electrolytes
- polymyxin B
- sodium picosulfate
- spironolactone
- streptomycin
- streptozocin
- sulfate bowel prep
- tenofovir disoproxil
- tobramycin
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- torsemide
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- voclosporin
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- willow bark
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- zonisamide
- zopapogene imadenovec
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- cutaneous reaction, severe
- acute kidney injury
- hypotension
- shock
- cardiac arrest
- arrhythmia
- thromboembolism (angiography use)
- extravasation symptoms
- thyroid dysfunction (peds patients)
- seizures
- pulmonary edema
Common Reactions
- headache
- injection site reaction
- nausea
- vasodilation
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; no human data available; no known risk of fetal harm based on animal data at 0.35-0.7x MRHD
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm not expected based on minimal drug excretion into milk; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for iopromide: none; CYP450: none
Excretion: for iopromide: urine 97% (100% unchanged); Half-life: 2h (main phase), 6.2h (terminal phase)
Subclass: Contrast Agents
Mechanism of Action
for iopromide: attenuates X-ray beams and opacifies vessels and anatomical structures, enhancing visualization of normal and pathological tissue (nonionic iodine-based contrast medium)
Formulary .
No Formulary Selected
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