Adult Dosing

Intra-arterial arteriography

• Note: The dose should be based on the individual patient, injection site, and study type.
• Carotid arteries: 10-14 mL, not to exceed 175 mL
• Verterbral arteries: 10-12 mL, not to exceed 175 mL
• Right coronary artery: 3-8 mL, not to exceed 200 mL
• Left coronary artery: 3-10 mL, not to exceed 200 mL
• Left ventricle: 20-45 mL, not to exceed 200 mL
• Renal arteries: 8-18 mL, not to exceed 250 mL
• Aortography: 30-70 mL, not to exceed 250 mL
• Major aorta branch: 10-70 mL, not to exceed 250 mL
• Aortofemoral Runoffs: 20-90 mL, not to exceed 250 mL
• Peripheral Arteries: 15-30 mL, not to exceed 250 mL

Intra-arterial digital subtraction angiography (IA-DSA)

• Note: The dose should be based on the individual patient, injection site, and study type.
• Carotid or vertebral arteries: 5-8 mL, not to exceed 175 mL
• Aortography: 10-50 mL, not to exceed 250 mL
• Major aorta branch: 2-10 mL, not to exceed 250 mL
• Aortofemoral runoffs: 6-15 mL, not to exceed 250 mL
• Peripheral arteries: 15-30 mL, not to exceed 250 mL

Pediatric Dosing

Intra-arterial arteriography

• Child 1-12 years: Cerebral, cardiac chambers and related major arteries, and visceral studies: 1-2 mL/kg; Max: 4 mL/kg

[Outline]

• Adult Dosing
• Pediatric Dosing

• Intra-arterial digital subtraction angiography (270 mgI/mL)
• Angiocardiography (left ventriculography and selective coronary arteriography) (320 mgI/mL)
• Peripheral arteriography (320 mgI/mL)
• Visceral arteriography (320 mgI/mL)
• Cerebral arteriography (320 mgI/mL)

• Hypersensitivity to any of the ingredients of the product
• Not indicated for intrathecal use
• In pediatrics, prolonged fasting and use of laxative before administration is contraindicated

• N/A

Renal Dose Adjustment (Based on CrCl)

• Renal impairment: Dose adjustments not defined; caution advised

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; caution advised

• Not intended for intrathecal use
• Inadvertent intrathecal administration of iodinated contrast media that are not indicated for intrathecal use has resulted in serious adverse reactions such as death, convulsions, cerebral hemorrhage, coma, paralysis, arachnoiditis, acute renal failure, cardiac arrest, seizures, rhabdomyolysis, hyperthermia, and brain edema
• Serious, rarely fatal, thromboembolic events causing myocardial infarction and stroke have been reported during angiocardiographic procedures with both ionic and nonionic contrast media
• Meticulous intravascular administration technique is necessary during angiographic procedures to minimize thromboembolic events
• Serious or rare fatal reactions have been associated with the administration of iodine-containing radiopaque media
• Use cautiously in patients with severely impaired renal function, combined renal and hepatic disease, combined renal and cardiac disease, severe thyrotoxicosis, myelomatosis, or anuria, particularly when large doses are administered
• Intravascularly administered iodine-containing radiopaque media are potentially hazardous in patients with multiple myeloma or other paraproteinaceous diseases, who are prone to disease induced renal insufficiency and/or renal failure
• Use caution and closely monitor patients for maintenance of normal hydration
• Patients should be adequately hydrated prior to and following intravascular administration of iodinated contrast agent
• Partial dehydration may predispose the patient to precipitation of the myeloma protein
• Preparatory dehydration may contribute to acute renal failure in patients with advanced vascular disease, congestive heart disease, diabetic patients, and other patients such as those on medications which alter renal function and the elderly with age-related renal impairment
• Intravascular use of iodinated radiopaque contrast agents in patients with hyperthyroidism has been associated with reports of thyroid storm following administration. Closely evaluate patients such patients before use of any contrast agent
• Use cautiously in patients with suspected pheochromocytoma
• Closely monitor blood pressure throughout the procedure, and measures for the treatment of hypertensive crisis should be readily available
• Intravascular use of contrast agents may promote sickling in patients who are homozygous for sickle cell disease
• Contrast agents are associated with increased risk of radiation exposure, and the decision to use agent should be based upon a careful evaluation of clinical, other radiologic data, and the results of unenhanced CT findings
• Diagnostic procedures should be carried out under the direction of personnel skilled and experienced in the particular procedure
• Pediatric patients with asthma, hypersensitivity to other medication and/or allergens, cyanotic and acyanotic heart disease, congestive heart failure, or a serum creatinine greater than 1.5 mg/dL may be at higher risk of experiencing an adverse reaction during and after administration of any contrast agent
• Use cautiously in patients suspected to have disrupted blood-brain barrier or in patients with normal blood-brain barrier and associated renal impairment

Pregnancy Category:B

Breastfeeding: It is not known whether this drug is excreted in human milk. Caution should be exercised when intravascular contrast agents are administered to nursing women because of the potential for adverse reactions, and consideration should be given to temporarily discontinue nursing.

• CNS: fatigue, malaise, convulsions, stupor, confusion
• NEURO: Cerebral vascular disorder, hypoesthesia
• MUSC: Back pain
• CV: Arrhythmias, cardiac failure, conduction abnormalities, hypotension, myocardial infarction, peripheral ischemia
• GI: Dyspepsia
• HENA: Hematuria, hematoma
• EENT: Pharyngeal edema, abnormal vision, tinnitus
• DERM: Increased sweating
• RESP: Asthma, bronchitis, dyspnea, pulmonary edema, rhinitis
• GU: Abnormal renal function, acute renal failure
• MISC: Flushing

• Dimeric, isosmolar, nonionic, water soluble, iodinated x-ray contrast agent; opacifies vessels in the path of flow of the contrast agent, permitting radiographic visualization of the internal structures until significant dilution and elimination occurs
• Metabolism: Unknown
• Excretion: 97% excreted unchanged in urine within 24 hr
• Half-life: 2.1 hr (+/- 0.1)

US Trade Name(s)

• Visipaque

US Availability

Visipaque

• INJ: 270 mgI/mL
• INJ: 320 mgI/mL

Canadian Trade Name(s)

• Visipaque

Canadian Availability

Visipaque

• INJ: 550 mg/mL
• INJ: 652 mg/mL

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Visipaque

Australian Availability

Visipaque

• INJ: 270 mgI/mL
• INJ: 550 mg/mL

[Outline]

Radiologic

Diagnostic Agents