Ioxaglate

Ioxaglate is an iodinated, water soluble, ionic, monoacidic dimeric contrast medium. It is a diagnostic radiopaque medium used in angiography, aortography, urography.


Brands
Adult Dose
Neonatal
Paedriatic
Dose: 1 to 2 ml/kg
Single Dose: 1.5 (1.5)
Frequency: As recommended.
Route:
Instructions:
Characteristics
belongs to Meglumine. . The Molecular Weight of Ioxaglate is 1464.10.
Contraindications
Ioxaglate is contraindicated in conditions like Hypersensitivity to any component of product.
Effects
The severe or irreversible adverse effects of Ioxaglate, which give rise to further complications include Myocardial infarction.The signs and symptoms that are produced after the acute overdosage of Ioxaglate include Seizures, Thromboembolism, Hypersensitivity reactions.The symptomatic adverse reactions produced by Ioxaglate are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Fever, Anxiety, Sweating, Chills, Rashes, Nausea and vomiting, Chest pain, dizziness.
Indications
Ioxaglate is primarily indicated in conditions like Angiography, Arthrography, Urography, and can also be given in adjunctive therapy as an alternative drug of choice in Hysterosalpingography.
Interactions
Ioxaglate is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAcebutololLimited data suggest that patients receiving beta blockers may have an increased risk of severe hypotensive and/or hypersensitivity reactions to parenteral iodinated contrast media. In addition, the treatment of allergic/anaphylactoid reactions in these patients may be more difficult. The mechanism is unknown. ModeratePatients who have received beta blockers should be closely monitored for adverse reactions to iodinated contrast media. If anaphylaxis occurs, clinicians should be aware that beta blockers may attenuate the response to epinephrine. Thus, larger doses of epinephrine may be necessary to overcome the bronchospasm, although such large doses can also cause excessive alpha adrenergic stimulation resulting in hypertension, reflex bradycardia, heart block, and possible potentiation of bronchospasm. Alternative treatments recommended include vigorous supportive care (e.g., fluids) and the use of parenteral beta agonists for bronchospasm and norepinephrine for hypotension.AldesleukinAn increased incidence (12.6%) of acute, atypical reactions to iodinated contrast media has been observed in patients who have been previously treated with interleukin-2. The cause and mechanism have not been established. Symptoms generally have an onset of 1 to 4 hours and may include nausea, vomiting, diarrhea, fever, chills, flu-like symptoms, joint pain, rash, pruritus, hypotension, edema, and oliguria. Reactions have typically been reported when patients received iodinated contrast media within 4 weeks after the last dose of interleukin-2, but have also occurred several months after interleukin treatment.ModeratePatients should be monitored for adverse reactions after receiving iodinated contrast media, and symptomatic treatment initiated as clinically appropriate.Amiodarone (HCl)The use of iodine-containing contrast media for coronary angiography in patients treated with certain antiarrhythmics such as amiodarone may result in significant prolongation of the QT interval. These contrast agents can be arrhythmogenic when injected into the coronary arteries and may have additive effects on cardiac repolarization when coadministered with antiarrhythmic agents that prolong the QT interval. ModerateCaution is advised if iodine-containing contrast media are used for coronary angiography in patients treated with class IA (e.g., disopyramide, quinidine, procainamide) or class III (e.g., amiodarone, dofetilide, ibutilide, sotalol) antiarrhythmic agents. Increased surveillance and ECG monitoring may be appropriate. Patients who receive outpatient angiographies should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of arrhythmia such as dizziness, palpitations, or syncope. Metformin (HCl)Administration of intravascular iodinated radiocontrast media in patients treated with biguanides such as metformin may precipitate lactic acidosis, a rare but potentially serious and fatal complication of biguanide therapy. Iodinated contrast material can cause acute alterations in renal function, including acute renal failure, which is a known risk factor for biguanide-induced lactic acidosis.MajorBiguanide therapy should be temporarily discontinued at the time of, or prior to, radiographic studies involving intravascular administration of iodinated contrast media, and not resumed until at least 48 hours after the procedure and renal function has been re-evaluated and determined to be normal.Metoprolol (Tartrate)Limited data suggest that patients receiving beta blockers may have an increased risk of severe hypotensive and/or hypersensitivity reactions to parenteral iodinated contrast media. In addition, the treatment of allergic/anaphylactoid reactions in these patients may be more difficult. The mechanism is unknown.ModeratePatients who have received beta blockers should be closely monitored for adverse reactions to iodinated contrast media. If anaphylaxis occurs, clinicians should be aware that beta blockers may attenuate the response to epinephrine. Thus, larger doses of epinephrine may be necessary to overcome the bronchospasm, although such large doses can also cause excessive alpha adrenergic stimulation resulting in hypertension, reflex bradycardia, heart block, and possible potentiation of bronchospasm. Alternative treatments recommended include vigorous supportive care (e.g., fluids) and the use of parenteral beta agonists for bronchospasm and norepinephrine for hypotension.Sodium IpodateRisk of renal toxicity may be increased when administration of Sodium Ipodate is followed by Ioxaglate, especially in patients with hepatic or biliary function impairment. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Urinanalysis Thyroid Function TestIncreased in serum creatininPhenolsulfonphthalein (PSP) excretion test
Risks
Drug should not be given to Paediatrics, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, and Geriatrics.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Store Below 30°C. Freezing is recommended. Protect from Sunlight.
Warnings
Diagnostic procedures which involve the use of iodinated intravascular contrast agents should be carried out under the direction of personnel skilled and experienced in the particular procedure to be performed. All procedures utilizing contrast media carry a definite risk of producing adverse reactions. While most reactions are minor, life-threatening and fatal reactions may occur without warning, and this risk must be weighed against the benefit of the procedure. Acute renal failure has been reported in diabetic patients with diabetic nephropathy and in susceptible nondiabetic patients (often elderly with pre-existing renal disease) following the administration of iodinated contrast agents. Therefore, careful consideration of the potential risks should be given before performing this radiographic procedure in these patients.Ioxaglate salts are excreted unchanged in human milk. Because of the potential for adverse effects in nursing infants, bottle feedings should be substituted for breast feedings for 24 hours following the administration of this drug.
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