AHFS Class:

36:68 Roentgenographic and Other Imaging Agents

Generic Name

• Iothalamate Meglumine

Iothalamate meglumine injection is available as a solution in concentrations ranging from 30 to 60% in vials and bottles in a variety of sizes.³³²⁰; ³³²¹; ³³²² Each mL of the 30% solution (Conray 30) contains iothalamate meglumine 300 mg, edetate calcium disodium 0.11 mg, and monobasic sodium phosphate 0.125 mg.³³²⁰ Each mL of the 43% solution (Conray 43) contains iothalamate meglumine 430 mg, edetate calcium disodium 0.11 mg, and monobasic sodium phosphate 0.115 mg.³³²¹ Each mL of the 60% solution (Conray) contains iothalamate meglumine 600 mg, edetate calcium disodium 0.09 mg, and monobasic sodium phosphate 0.125 mg.³³²²

Iothalamate meglumine also is available as a 17.2% solution for cystography and cystourethrography; this product is not intended for intravascular or intrathecal administration.³³²³

Some examples of iothalamate meglumine products are listed in Table 1.

Table 1. Some Representative Iothalamate Meglumine Products³³²⁰; ³³²¹; ³³²²; ³³²³

Sodium Content

Each mL of iothalamate meglumine 30% solution contains approximately 0.04 mg sodium.³³²⁰

pH

Iothalamate meglumine 43%: From 6.6 to 7.6.³³²¹

Iothalamate meglumine 30 and 60%: From 6.5 to 7.7.³³²⁰; ³³²²

Osmolarity

Iothalamate meglumine 30%: 500 mOsml/L.³³²⁰

Iothalamate meglumine 43%: 800 mOsml/L.³³²¹

Iothalamate meglumine 60%: 1000 mOsml/L.³³²²

Osmolality

Iothalamate meglumine 30, 43, and 60% solutions are hypertonic, having osmolalities of 600, 800, and 1400 mOsm/kg, respectively.³³²⁰; ³³²¹; ³³²²

Trade Name(s)

Conray, Conray 30, Conray 43

Iothalamate meglumine 30, 43, and 60% solutions may be administered intravenously, intra-arterially, or by injection into pancreatic and biliary ducts, specific to the procedure for which the solution is being employed.³³²⁰; ³³²¹; ³³²² Solutions should be warmed to body temperature prior to administration.³³²⁰; ³³²¹; ³³²² For certain procedures, the manufacturer states that iothalamate meglumine 60% may be diluted with sodium chloride injection or sterile water for injection.³³²²

If a minor reaction occurs during iothalamate meglumine administration, the injection should be slowed or stopped until the reaction has subsided.³³²⁰; ³³²¹; ³³²² If a major reaction occurs, administration of the drug should be discontinued immediately.³³²⁰; ³³²¹; ³³²²; ³³²³

Iothalamate meglumine solutions are not indicated for intrathecal administration.³³²⁰; ³³²¹; ³³²²; ³³²³ Care must be taken to ensure that the drug is not administered intrathecally.³³²⁰; ³³²¹; ³³²²; ³³²³

Iothalamate meglumine solution 17.2% (Cysto-Conray II) is instilled by gravity flow or syringe into the urinary bladder; this solution should not be administered intravascularly or intrathecally.³³²³

Iothalamate meglumine solutions are clear.³³²⁰; ³³²¹; ³³²² Iothalamate meglumine 30, 43, and 60% solutions should be stored below 30°C.³³²⁰; ³³²¹; ³³²² Crystallization does not occur at room temperature, but exposure to very cold temperatures may result in crystallization of the salt.³³²⁰; ³³²¹; ³³²² If crystallization occurs, the solution should be brought to room temperature; intermittent³³²⁰ or vigorous shaking³³²¹; ³³²² also may be necessary to redissolve the crystals. The speed of dissolution may be increased for some products by heating the vials in circulating warm air.³³²¹; ³³²²

The manufacturer states that iothalamate meglumine solutions must not be mixed in the same syringe with corticosteroids or antihistamines due to the potential for chemical incompatibility.³³²⁰; ³³²¹; ³³²²

Iothalamate meglumine solution should be visually inspected for particulate matter or discoloration prior to administration.³³²⁰; ³³²¹; ³³²²

pH Effects

Iothalamate meglumine is sensitive to low pH values. At reported pH values of about 2.4 to 2.7, turbidity or frank precipitation may appear in the 60% product.⁴⁷⁹

Light Effects

Iothalamate meglumine solutions are light sensitive and should be protected from strong daylight and direct sunlight.³³²⁰; ³³²¹; ³³²²

Syringes

Iothalamate meglumine 60% was stored in polystyrene syringes (Pharmaseal) at 25 and 37°C. No apparent changes were noted over 5 days.⁵³⁰

Syringe material is one of many factors that may contribute to the development of thromboembolic events that have been reported with the use of contrast media in angiographic procedures.³³²⁰; ³³²¹; ³³²² The use of plastic syringes rather than glass has been reported to decrease, but not entirely eliminate, the likelihood of in vitro clotting.³³²⁰; ³³²¹; ³³²²

Drugs in Syringe Compatibility

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions February 21, 2018. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.