Interactions
Metrizamide 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. MajorPatients 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.AldesleukinIntrathecal administration of iodinated contrast media may induce seizures. There may be a theoretical risk of increased seizure potential when iodinated contrast agents are used with other substances that can reduce the seizure threshold such as aldesleukin.MajorAldesleukin should preferably be withheld for at least 48 hours prior to and 24 hours following intrathecal administration of iodinated contrast media. Patients should be monitored for adverse reactions during and after the myelography, and symptomatic treatment initiated as clinically appropriate.AminophyllineIntrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of increased seizureMajorDrugs that can lower the seizure threshold should preferably be withheld for at least 48 hours prior to and 24 hours following intrathecal administration of iodinated contrast media, provided that temporary interruption of therapy does not pose an undue risk to the patient. Otherwise, close monitoring is advised during and after contrast administration.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.Caution 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.AmphetamineIntrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of increased seizure.MajorDrugs that can lower the seizure threshold should preferably be withheld for at least 48 hours prior to and 24 hours following intrathecal administration of iodinated contrast media, provided that temporary interruption of therapy does not pose an undue risk to the patient. Otherwise, close monitoring is advised during and after contrast administration.Betaxolol (HCl)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.IpodateRenal toxicity has been reported in a few patients with liver dysfunction who were given an oral cholecystographic agent followed by intravenous contrast agents. The mechanism of interaction has not been described.ModerateAdministration of any intravascular contrast agent should be deferred for 48 hours in patients with hepatic or biliary disorders who have recently received an oral cholecystographic contrast agent.OxymorphoneIntrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of increased seizure potential when used with selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), and/or any substance that can reduce the seizure threshold (e.g., carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, theophylline). These agents are often individually epileptogenic and may have additive effects when combined.MajorDrugs that can lower the seizure threshold should preferably be withheld for at least 48 hours prior to and 24 hours following intrathecal administration of iodinated contrast media, provided that temporary interruption of therapy does not pose an undue risk to the patient. Otherwise, close monitoring is advised during and after contrast administration. The manufacturers typically recommend avoiding concomitant administration of phenothiazines (including those used for their antihistamine properties), monoamine oxidase inhibitors, tricyclic antidepressants, central nervous system stimulants, and psychoactive drugs.Procainamide (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.Timolol (Maleate)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. 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.