iomeprol: clinical use

Prescribing considerations

• Confirm that contrast-enhanced CT or CT angiography is clinically justified.
• Assess previous contrast reactions, allergy, asthma, renal function, diabetes, hydration, cardiac disease, thyroid disease and relevant neurological disorders.
• Ensure resuscitation facilities are immediately available and observe after administration.
• Use careful injection technique and respond promptly to suspected extravasation.

Contraindications and cautions

• Hypersensitivity to iomeprol or any excipient.
• Do not re-administer after a serious iomeprol-associated cutaneous reaction such as SJS, TEN, AGEP or DRESS.

Monitoring

• Assess renal function in patients at risk and before repeat contrast exposure.
• Monitor for immediate hypersensitivity, cardiovascular or respiratory reactions and inspect the injection site.
• Evaluate thyroid function after exposure in children younger than 3 years and in newborns exposed in utero.
• Consider contrast-induced encephalopathy if acute neurological dysfunction develops.

Clinical pharmacology

Iomeprol is a low-osmolality, non-ionic iodinated contrast agent. It distributes mainly in extracellular fluid, has negligible protein binding, is not metabolised and is eliminated predominantly through the kidneys.

Formulation and product differences

• The selected product is a clear, colourless to pale-yellow solution in a glass multi-dose container.
• It is intended for use with an approved multipatient automatic injector; the stopper should be pierced once and patient connectors replaced after each patient.
• It should not be mixed with other medicines.