Iodipamide Meglumine

Iodipamide Meglumine Brand Name– Cholografin Meglumine

What is Iodipamide Meglumine

Iodipamide meglumine is an iodinated, ionic radiographic contrast agent indicated for intravenous cholangiography and cholecystography.

Iodipamide meglumine is only approved for intravenous administration; avoid inadvertent intrathecal administration as this can result in serious adverse events, including death.

Serious and potentially fatal adverse events (i.e., hypersensitivity reactions, severe cutaneous adverse reactions, acute renal failure) may also occur during intravascular use.

To minimize the toxicity risk, ensure the patients are adequately hydrated.

Indications

  • hepatobiliary system dysfunction diagnosis

NOTE: Patients should be well hydrated prior to and following iodipamide meglumine administration. A suggested common regimen in eligible patients (e.g., those patients in which fluid administration would not be contraindicated) is 1 mL/kg/hour of 0.9% Sodium Chloride Injection starting at least 4 hours prior to the procedure or exam and continuing for at least 12 hours after.

NOTE: In patients with a history of allergic reaction to contrast media or iodine, those with a history of asthma or allergic reactions to drugs or foods, nonionic contrast media should be used. In addition, consider administering prednisone 50 mg PO (or equivalent dose of other steroids) 13 hours, 7 hours, and 1 hour prior to the exam or procedure plus diphenhydramine 50 mg IM or PO 1 hour prior to the procedure.

The administration of prophylactic steroids and antihistamines does not prevent all hypersensitivity reactions, but reduces the likelihood and may decrease the severity of the reaction.

Side Effects

  1. acute generalized exanthematous pustulosis (AGEP)
  2. anaphylactoid reactions
  3. angioedema
  4. arachnoiditis
  5. bronchospasm
  6. cardiac arrest
  7. cerebral edema
  8. chills
  9. coma
  10. dizziness
  11. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  12. erythema
  13. fever
  14. flushing
  15. headache
  16. hypersalivation
  17. hyperthermia
  18. hyperthyroidism
  19. hypotension
  20. hypothyroidism
  21. laryngospasm
  22. maculopapular rash
  23. nasal congestion
  24. nausea
  25. nephrotoxicity
  26. pallor
  27. pruritus
  28. rash
  29. restlessness
  30. rhabdomyolysis
  31. seizures
  32. skin discoloration
  33. Stevens-Johnson syndrome
  34. stroke
  35. thyrotoxicosis
  36. toxic epidermal necrolysis
  37. tremor
  38. urticaria
  39. vomiting

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • asthma
  • atopy
  • breast-feeding
  • coagulopathy
  • dehydration
  • diabetes mellitus
  • emphysema
  • extravasation
  • females
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypothyroidism
  • infants
  • intrathecal administration
  • iodine hypersensitivity
  • laboratory test interference
  • multiple myeloma
  • neonates
  • pheochromocytoma
  • pregnancy
  • premature neonates
  • pulmonary disease
  • radiation exposure
  • radiopaque contrast media hypersensitivity
  • renal disease
  • renal failure
  • renal impairment
  • serious rash
  • sickle cell disease
  • thromboembolic disease
  • thyroid disease
  • thyrotoxicosis

Interactions

  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acyclovir
  • Aldesleukin, IL-2
  • Alogliptin; Metformin
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Canagliflozin; Metformin
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Phenylephrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Phenylephrine
  • Codeine; Phenylephrine; Promethazine
  • Dapagliflozin; Metformin
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Dopamine
  • Droxidopa
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enflurane
  • Ephedrine
  • Ertugliflozin; Metformin
  • Ethanol
  • Etomidate
  • Fospropofol
  • General anesthetics
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Guaifenesin; Phenylephrine
  • Halothane
  • Hydrocodone; Phenylephrine
  • Isoflurane
  • Ketamine
  • Linagliptin; Metformin
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Midodrine
  • Nonsteroidal antiinflammatory drugs
  • Norepinephrine
  • Oxaliplatin
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Propofol
  • Sevoflurane
  • Sodium Iodide
  • Valacyclovir
  • Vasopressors
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