Iohexol Explained

Verifiedfields:changed
Verifiedrevid:461935422
Tradename:Omnipaque, Hexopaque, Oraltag, others
Dailymedid:Iohexol
Routes Of Administration:Intrathecal, intravascular, by mouth, intracavital, rectal
Atc Prefix:V08
Atc Suffix:AB02
Legal Ca:Rx-only
Legal Ca Comment:[1] [2]
Legal Us:Rx-only
Legal Status:Rx-only
Protein Bound:Low
Metabolism:Nil
Elimination Half-Life:Variable
Excretion:Kidney, unchanged
Cas Number:66108-95-0
Pubchem:3730
Drugbank:DB01362
Chemspiderid:3599
Unii:4419T9MX03
Kegg:D01817
Chebi:31709
Chembl:1200455
Synonyms:5-[N-(2,3-Dihydroxypropyl)acetamido]-2,4,6-triiodo-N,N'-bis(2,3-dihydroxypropyl)isophthalamide
Iupac Name:1-N,3-N-Bis(2,3-dihydroxypropyl)-5-[''N''-(2,3-dihydroxypropyl)acetamido]-2,4,6-triiodobenzene-1,3-dicarboxamide
C:19
H:26
I:3
N:3
O:9
Smiles:O=C(N(c1c(I)c(c(I)c(c1I)C(=O)NCC(O)CO)C(=O)NCC(O)CO)CC(O)CO)C
Stdinchi:1S/C19H26I3N3O9/c1-8(29)25(4-11(32)7-28)17-15(21)12(18(33)23-2-9(30)5-26)14(20)13(16(17)22)19(34)24-3-10(31)6-27/h9-11,26-28,30-32H,2-7H2,1H3,(H,23,33)(H,24,34)
Stdinchikey:NTHXOOBQLCIOLC-UHFFFAOYSA-N
Melting Point:174
Melting High:180

Iohexol, sold under the trade name Omnipaque among others, is a contrast agent used for X-ray imaging. This includes when visualizing arteries, veins, ventricles of the brain, the urinary system, and joints, as well as during computed tomography (CT scan). It is given by mouth, injection into a vein, or into a body cavity.

Side effects include vomiting, skin flushing, headache, itchiness, kidney problems, and low blood pressure. Less commonly allergic reactions or seizures may occur. Allergies to povidone-iodine or shellfish do not affect the risk of side effects more than other allergies.[3] Use in the later part of pregnancy may cause hypothyroidism in the baby.[4] Iohexol is an iodinated non-ionic radiocontrast agent.[5] It is in the low osmolar family.[6]

Iohexol was approved for medical use in 1985.[7] It is on the World Health Organization's List of Essential Medicines.[8] [9]

Chemistry

The osmolality of iohexol ranges from 322 mOsm/kg—approximately 1.1 times that of blood plasma—to 844 mOsm/kg, almost three times that of blood.[10] Despite this difference, iohexol is still considered a low-osmolality contrast agent; the osmolality of older agents, such as diatrizoate, may be more than twice as high.[11]

Adverse effects

The most common side effects after intravenous injections are: pain at the site of injection (3%), blurring of vision (2%), nausea (2%), arrhythmia (2%), taste perversion (1%), hypotension (0.7%), and vomiting (0.7%).

Society and culture

Naming

It is sold under the brand names Omnipaque.[12] It is also sold as a density gradient medium under the names Accudenz, Histodenz, and Nycodenz.[13] [14]

Available forms

It is available in various concentrations, from 140[15] to 350[16] milligrams of iodine per milliliter.[15] Iohexol can given as intrathecal, intravascular, oral, rectal, intraarticular, or into the body cavity.[15]

Notes and References

  1. Web site: Product monograph brand safety updates . Health Canada . February 2024 . 24 March 2024.
  2. Web site: Regulatory Decision Summary for Omnipaque . Drug and Health Products Portal . 29 December 2023 . 2 April 2024.
  3. Book: ACR Manual on Contrast Media v10.3. 2017. 2017. American College of Radiology. 9781559030120. 6. 1 January 2018. live. https://web.archive.org/web/20180101145210/https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf. 1 January 2018.
  4. Book: Briggs GG, Freeman RK, Yaffe SJ . Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 2011. Lippincott Williams & Wilkins. 9781608317080. 761. en. live. https://web.archive.org/web/20170101161434/https://books.google.ca/books?id=OIgTE4aynrMC&pg=PA761. 1 January 2017.
  5. Book: WHO Model Formulary 2008 . 2009 . 9789241547659 . ((World Health Organization)) . Stuart MC, Kouimtzi M, Hill SR . 10665/44053 . World Health Organization . World Health Organization . free . 317–8 .
  6. Book: Sutton D, Young JW . A Short Textbook of Clinical Imaging. 2012. Springer Science & Business Media. 9781447117551. 235. en. live. https://web.archive.org/web/20170101161432/https://books.google.ca/books?id=muflBwAAQBAJ&pg=PA235. 1 January 2017.
  7. Book: Broe ME, Porter GA, Bennett WM, Verpooten GA . Clinical Nephrotoxins: Renal Injury from Drugs and Chemicals. 2013. Springer Science & Business Media. 9789401590884. 325. en. live. https://web.archive.org/web/20170101001423/https://books.google.ca/books?id=tkPwCAAAQBAJ&pg=PA325. 1 January 2017.
  8. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
  9. Book: Hamilton R . Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. 2015. Jones & Bartlett Learning. 9781284057560. 171.
  10. Web site: Omnipaque (Iohexol) injection. Product label . GE Healthcare . GE Healthcare . May 2006 . 28 March 2007 . . DailyMed.
  11. Web site: Hypaque (Diatrizoate Meglumine and Diatrizoate Sodium) injection, solution. Product label . Amersham Health . April 2006 . 29 March 2007 . . DailyMed . live . https://web.archive.org/web/20110523223457/http://dailymed.nlm.nih.gov/dailymed/fdaDrugXsl.cfm?id=997&type=display . 23 May 2011 .
  12. Web site: Omnipaque . Health Products Regulatory Authority . Ireland . January 2018 . 31 July 2020 .
  13. Web site: HistoDenz . D2158 . https://web.archive.org/web/20151120190729/https://www.sigmaaldrich.com/content/dam/sigma-aldrich/docs/Sigma/Product_Information_Sheet/d2158pis.pdf . 20 November 2015 . Product information sheet . Sigma-Aldrich . 19 November 2015 .
  14. Web site: Nycodenz®: A universal density gradient medium . https://web.archive.org/web/20150226092521/http://www.axis-shield-density-gradient-media.com/Leaflet%20Nycodenz.pdf . 26 February 2015 . Axis-Shield Density Gradient Media. . 19 November 2015 .
  15. Web site: Highlights of prescribing information for Omnipaque. US Food and Drug Administration . 13 December 2022 . https://web.archive.org/web/20220711204218if_/https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/018956s101lbl.pdf . 11 July 2022.
  16. Book: Austria-Codex. Haberfeld H . Omnipaque 350 mg J/ml Infusionsflasche. Österreichischer Apothekerverlag. Vienna. 2020. German.

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