Comparative Pharmacology
Head-to-head clinical analysis: HYPAQUE SODIUM 20 versus HYPAQUE M 90.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYPAQUE SODIUM 20 versus HYPAQUE M 90.
HYPAQUE SODIUM 20% vs HYPAQUE-M,90%
Head-to-head clinical comparison of therapeutic indices and safety profiles.
Hypaque sodium is an ionic monomeric iodinated contrast medium that absorbs X-rays due to its iodine content, providing radiographic contrast. It increases the density of vascular structures and organ parenchyma, allowing visualization during imaging procedures.
Ionic, high-osmolality iodinated contrast agent that absorbs X-rays, enhancing radiographic contrast by attenuating X-rays in tissues where it distributes.
Intravascular contrast agent for computed tomography (CT) imagingIntravascular contrast agent for angiographyIntravascular contrast agent for urographyIntravascular contrast agent for digital subtraction angiographyOral contrast agent for gastrointestinal studies (off-label)
Intravascular use for angiography, urography, and contrast enhancement in computed tomography (CT)Intrathecal use for myelography
Intravenous: 30-60 mL (6-12 g iodine) administered as a bolus or infusion for excretory urography; may be repeated up to a total of 125 mL (25 g iodine). Intra-arterial: Variable based on procedure, typically 8-30 mL for selective angiography.
Intra-arterial or intravenous injection: 30-60 mL of 90% solution, administered as a bolus or infusion over 1-2 minutes; repeat dosing not recommended.
None Documented
None Documented
Terminal elimination half-life: 1-2 hours in normal renal function; prolonged in renal impairment.
Terminal half-life: 1-2 hours (normal renal function); prolonged in renal impairment
Hypaque sodium is not significantly metabolized and is excreted unchanged primarily by glomerular filtration.
Not metabolized; eliminated unchanged by glomerular filtration.
Renal: >95% unchanged via glomerular filtration within 24 hours; <5% biliary/fecal.
Renal: >95% unchanged; biliary/fecal: <5%
Minimal, <10%; primarily albumin.
Minimal (<10%); primarily albumin
0.2-0.3 L/kg; limited to extracellular fluid.
0.2-0.3 L/kg (confined to extracellular fluid)
Oral: <1% (poor absorption, used for GI opacification); not applicable for IV.
Intravenous: 100%; Oral: not administered orally due to GI irritation
GFR < 30 mL/min: Avoid use; if necessary, reduce dose by 50% and ensure adequate hydration. GFR 30-60 mL/min: Use with caution, consider lower doses and monitor renal function. GFR > 60 mL/min: No adjustment required.
Contraindicated in patients with GFR <30 mL/min/1.73 m² (anuric or severely impaired renal function). For GFR 30-60 mL/min/1.73 m²: reduce dose by 50%, ensure adequate hydration, and monitor renal function for 48 hours post-dose.
No specific adjustment for mild to moderate impairment (Child-Pugh A or B). Severe impairment (Child-Pugh C): Use with caution due to potential for delayed excretion; monitor for adverse effects.
No specific dose adjustment required for Child-Pugh Class A or B. For Child-Pugh Class C: use lowest effective dose (e.g., 30 mL of 90% solution) and ensure adequate hydration due to potential hepatic encephalopathy risk with high osmolar load.
Intravenous: 1-2 mL/kg (0.2-0.4 g iodine/kg) for excretory urography, not to exceed 30 mL. Intra-arterial: 0.5-1 mL/kg per injection, adjusted based on procedure.
0.5-1.5 mL/kg of 90% solution (maximum 30 mL) intra-arterial or intravenous, administered as a slow injection over 1-3 minutes; not recommended for neonates (<1 month) due to high osmolarity.
Start with lower doses (e.g., 50% of adult dose) and titrate upward as needed. Monitor renal function closely due to age-related decline; ensure adequate hydration.
Initiate with lowest effective dose (e.g., 30 mL of 90% solution) and monitor renal function closely due to age-related GFR decline; ensure adequate hydration before and after procedure.
Not for intrathecal use. Intrathecal administration may cause severe adverse reactions including convulsions, cerebral hemorrhage, coma, paralysis, arachnoiditis, and death.
Risk of fatal anaphylactic reactions; severe adverse reactions (including death) have occurred with intravascular administration. Resuscitative equipment and trained personnel must be immediately available.
["Risk of acute kidney injury, particularly in patients with pre-existing renal impairment, diabetes mellitus, or volume depletion","Anaphylactoid reactions, including anaphylaxis, bronchospasm, and hypotension","Thyroid storm in patients with hyperthyroidism or thyroid nodules","Severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome","Cardiovascular adverse events including arrhythmias and cardiac arrest","Vasovagal reactions","Extravasation leading to tissue injury"]
["Risk of acute kidney injury in patients with pre-existing renal impairment, diabetes, or dehydration","Hypersensitivity reactions including anaphylaxis","Thyroid storm in patients with hyperthyroidism","Extravasation risk during administration","Lactic acidosis potential in patients with metabolic disorders"]
["Known hypersensitivity to Hypaque sodium or any of its components","History of anaphylactoid reaction to iodinated contrast media","Intrathecal administration (contraindicated due to risk of neurotoxicity)","Severe renal impairment (e.g., estimated glomerular filtration rate <30 mL/min/1.73 m²)","Concurrent administration of metformin in patients with acute kidney injury or severe renal impairment (risk of lactic acidosis)"]
["Known hypersensitivity to diatrizoate or any formulation component","Severe oliguria or anuria","Concurrent administration with biguanides (metformin) due to risk of lactic acidosis"]
Data Pending Review
Data Pending Review
No specific food interactions. Avoid alcohol for 24 hours before procedure to reduce risk of nausea and vomiting. Maintain adequate hydration with clear fluids.
No specific food interactions, but adequate hydration with clear fluids is recommended before and after administration to reduce nephrotoxicity risk.
Hypaque Sodium 20% (diatrizoate sodium) is a radiocontrast agent. It is not known to be teratogenic in humans. However, because it contains iodine, fetal thyroid function may be affected, particularly if exposure occurs during the second or third trimester. The risk of fetal hypothyroidism is theoretical and low with single exposure. Use only if clearly needed.
FDA Pregnancy Category D. Iodinated contrast media, including diatrizoate meglumine and sodium diatrizoate, cross the placenta and can cause transient neonatal hypothyroidism if used during pregnancy. First trimester exposure: potential but undocumented teratogenicity. Second and third trimesters: risk of fetal thyroid suppression. Use only if essential for maternal diagnosis.
Minimal excretion into breast milk; M/P ratio is not available. The amount ingested by a nursing infant is likely negligible. However, due to potential hypersensitivity or iodine effects, caution is advised. The manufacturer recommends discontinuing breastfeeding for 24 hours after administration, but this may be excessive. Discuss with patient.
Minimal excretion into breast milk; estimated infant dose <1% of maternal. M/P ratio not established. Consider pump and discard for 24 hours post-administration to minimize potential exposure.
No specific dose adjustments are recommended for pregnancy. However, consider the increased plasma volume and renal blood flow in pregnancy; the contrast agent is renally excreted, so clearance may be slightly increased, but no dose change is typically needed. Use the lowest necessary dose.
No specific dose adjustment required. Consider lower doses to minimize fetal exposure. Avoid repeated or high-dose studies unless critical. Maintain maternal hydration to reduce risk of nephropathy.
Category C
Category C
Administer slowly intravenously to minimize pain and thrombosis risk. Pre-warm to body temperature to reduce viscosity. Ensure adequate hydration before and after use to prevent renal impairment. Have emergency equipment available for anaphylactoid reactions. Use with caution in patients with sickle cell disease due to risk of sickling. Contraindicated in myelography due to neurotoxicity. Check for iodine allergy history.
HYPAQUE-M,90% (diatrizoate meglumine and diatrizoate sodium) is a high-osmolar ionic iodinated contrast medium used for angiocardiography and aortography. Pre-procedure hydration and screening for renal impairment (eGFR <30 mL/min/1.73m²) or prior contrast reaction are critical. Have emergency resuscitation equipment available. Monitor for signs of contrast-induced nephropathy, anaphylactoid reactions, and delayed hypersensitivity. Consider premedication with corticosteroids and antihistamines in at-risk patients.
You may experience a warm sensation or metallic taste during injection.Drink plenty of fluids before and after the procedure to protect your kidneys.Report any symptoms of allergic reaction such as hives, itching, or difficulty breathing immediately.You may have to fast for a few hours before the test depending on the procedure.Inform your doctor if you are pregnant, diabetic, or have kidney problems.You may notice a salty or metallic taste after the injection.
This contrast agent may cause warmth, flushing, or metallic taste during injection.Notify your doctor if you have a history of asthma, drug allergies, kidney problems, or diabetes.Increase water intake before and after procedure as directed.Report symptoms like hives, itching, difficulty breathing, or swelling of the throat immediately.Rare risk of delayed skin rash days after procedure.