Iopromide

BRAND NAMES

Iopromide is sold under brand names like Ultravist, Iopamiro, and Iomeron. It is available as an injectable solution for intravenous use in diagnostic imaging. Different brands may vary in iodine concentration and volume depending on the procedure. Some brands are preferred for CT scans, while others are used in angiography. Selection depends on availability and specific imaging requirements.

MECHANISM OF ACTION

Iopromide is an iodinated contrast agent that enhances X-ray imaging. Its iodine atoms absorb X-rays, creating clear contrast between blood vessels, organs, and surrounding tissues. Being non-ionic, it reduces the risk of allergic reactions and osmolarity-related side effects. It distributes in the vascular and extracellular spaces to highlight structures. The mechanism is physical, improving visibility without altering physiological processes.

PHARMACOKINETICS

Absorption

Iopromide is administered intravenously, allowing immediate and complete absorption. It bypasses the gastrointestinal system, so absorption is not affected by food. Once injected, it quickly enters the bloodstream and circulates throughout the body. Rapid distribution ensures target organs are visible within minutes. This allows timely imaging for accurate diagnosis.

Distribution

After entering the blood, iopromide distributes mainly in the extracellular fluid. It does not significantly bind to plasma proteins or enter cells. Organs with high blood flow, such as the kidneys, liver, and heart, receive higher concentrations. Rapid distribution ensures imaging can be performed soon after injection. Its non-ionic nature prevents significant fluid shifts, reducing side effects.

Metabolism

Iopromide is not metabolized in the human body and remains chemically unchanged. This reduces the risk of toxic metabolites forming. Its inert nature makes its pharmacokinetics predictable. No liver metabolism occurs, making it safer for patients with liver disease. The unchanged drug is ready for renal excretion.

Excretion

Iopromide is primarily excreted through the kidneys in urine. Approximately 90–95% is eliminated unchanged within 24 hours. Reduced kidney function can slow excretion and increase the risk of adverse effects. Minimal fecal elimination occurs. Adequate hydration helps speed up clearance and reduce side effects.

PHARMACODYNAMICS

Iopromide’s effect is purely physical, enhancing the contrast of tissues during imaging. It increases radiodensity in blood vessels, organs, and lesions for clear visualization. Non-ionic properties reduce osmolarity-related side effects. The effect is temporary, lasting until the agent is excreted. This facilitates accurate and safe diagnostic procedures.

ADMINISTRATION

Iopromide is administered intravenously by trained medical personnel. Dose and injection rate depend on the imaging procedure. It is used in CT scans, angiography, and urography. Sterile technique and patient monitoring are required during administration. Hydration before and after injection helps protect the kidneys.

DOSAGE AND STRENGTH

Iopromide is available in concentrations from 150 mg/mL to 370 mg/mL of iodine. Dose is calculated based on patient weight, age, and type of imaging. Pediatric doses are adjusted according to body surface area. Injection volume depends on the target organ and procedure. Correct dosing ensures both image quality and patient safety.

DRUG INTERACTIONS

Iopromide has minimal drug interactions due to its inert nature. Nephrotoxic drugs may increase kidney injury risk. Concomitant use of diuretics or NSAIDs requires caution. Use with other contrast agents may stress kidney function. Monitoring medications ensures safe imaging in at-risk patients.

FOOD INTERACTIONS

Food intake does not affect iopromide pharmacokinetics or imaging quality. It can be administered irrespective of meals. Hydration is more important to ensure renal clearance. High salt or sugar intake does not interfere with contrast performance. Drinking fluids after administration helps reduce adverse effects.

CONTRAINDICATIONS

Iopromide is contraindicated in patients with known hypersensitivity to iodine. Severe renal impairment or uncontrolled hyperthyroidism increases risk. Patients with multiple allergies need careful premedication and monitoring. Pregnancy and breastfeeding require caution. Cardiac failure or electrolyte imbalances are relative contraindications.

SIDE EFFECTS

Mild side effects include nausea, vomiting, and headache. Some patients may experience flushing, dizziness, or hypotension. Rare allergic reactions include rash, itching, or urticaria. Severe reactions like anaphylaxis are uncommon but possible. Most side effects are transient and resolve with observation.

OVER DOSE

Overdose of iopromide is rare due to controlled diagnostic doses. Symptoms may include excessive nausea, vomiting, or hypotension. Kidney function could be transiently affected in severe cases. Supportive care and hydration are the main treatments. There is no specific antidote, as the drug is inert.

TOXICITY

Iopromide is generally low in systemic toxicity. Kidney impairment is the main concern in at-risk patients. Allergic reactions are rare but possible in sensitive individuals. Low osmolarity reduces adverse effects compared to older contrast agents. Toxicity is dose-dependent and manageable with proper precautions.