Comparative Pharmacology
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 150.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 150.
ULTRAVIST (PHARMACY BULK) vs ULTRAVIST 150
Head-to-head clinical comparison of therapeutic indices and safety profiles.
Iodinated nonionic radiographic contrast agent that attenuates X-rays due to its iodine content, providing vascular and tissue opacification during imaging.
Nonionic iodinated contrast medium that attenuates X-rays, enhancing vascular and tissue contrast due to iodine content. It distributes in extracellular fluid and is excreted unchanged by glomerular filtration.
Coronary angiography and ventriculographyPeripheral angiographyVisceral angiographyAortographyCerebral angiographyIntravenous urographyComputed tomography enhancementDigital subtraction angiography
Intravascular contrast agent for computed tomography (CT), angiography, urography, venographyIntrathecal use for myelography (off-label)Opacification of body cavities (off-label)
300 mg iodine/mL, 370 mg iodine/mL: 0.6-1.5 mL/kg IV for CT; 100-300 mL IV for angiography. Repeat doses allowed up to maximum total dose of 500 mL.
Intravascular administration: 1-2 mL/kg of ULTRAVIST 150 (150 mg iodine/mL) as a bolus or rapid infusion. Typical adult dose ranges from 50-200 mL depending on procedure and patient weight. Not to exceed 7.5 mL/kg.
None Documented
None Documented
Terminal elimination half-life is approximately 1.5-2 hours in patients with normal renal function. Prolonged in renal impairment (up to 10-30 hours) or severe disease.
Terminal elimination half-life approximately 2 hours (range 1.5–3 hours) in patients with normal renal function; prolonged in renal impairment (up to 30 hours in severe impairment)
Not metabolized; eliminated unchanged via glomerular filtration.
Not metabolized; eliminated unchanged via glomerular filtration.
Primarily renal by glomerular filtration; approximately 60-70% eliminated unchanged in urine within 6 hours, with >90% excreted within 24 hours. Less than 1% biliary or fecal.
Primarily renal (glomerular filtration, >95% of injected dose excreted unchanged in urine within 24 hours; negligible biliary/fecal excretion <2%)
Low; approximately 10-15% bound to plasma proteins, mainly albumin.
Negligible (<2%) bound to plasma proteins (primarily albumin)
Approximately 0.2-0.3 L/kg, indicating distribution primarily in extracellular fluid.
Approximately 0.3–0.4 L/kg, reflecting distribution primarily in extracellular fluid space; does not cross intact blood-brain barrier
Not applicable for oral route; administered intravenously, bioavailability is 100%.
Intravenous: 100% (administered directly into bloodstream); no oral bioavailability due to degradation in GI tract; other routes not relevant
eGFR <30 mL/min/1.73 m²: Administer with caution, ensure adequate hydration, consider lowest possible dose. eGFR <15 mL/min: Avoid use unless dialysis immediately available.
eGFR 30-59 mL/min/1.73m²: Use lowest diagnostic dose, ensure adequate hydration, consider alternative imaging if possible. eGFR <30 mL/min/1.73m²: Avoid use unless essential; if necessary, use minimum dose, hydrate, and monitor renal function for 48-72 hours. Hemodialysis patients: Use only if clearly indicated; no dose adjustment needed but contrast removal via dialysis is minimal.
No specific dose adjustment recommended based on Child-Pugh class; use caution in severe hepatic impairment due to potential coagulation abnormalities.
No specific dose adjustment required for hepatic impairment. Caution in severe hepatic disease due to increased risk of contrast-induced nephropathy.
CT: 1-2 mL/kg (300 mg I/mL) IV; Angiography: 1-2 mL/kg (300 mg I/mL) IV. Maximum single dose: 4 mL/kg. Adjust for age and clinical condition.
Weight-based: 1-2 mL/kg intravenously, not to exceed total dose of 5 mL/kg. Specific protocols: CT head: 1-2 mL/kg; CT body: 2 mL/kg. Administer as slow bolus or infusion.
Start with lower end of dosing range; monitor renal function (eGFR) and hydration status; increased risk of nephrotoxicity and volume overload.
Use lowest diagnostic dose. Ensure adequate hydration before and after procedure. Monitor renal function (eGFR) and adjust volume accordingly. Higher risk of adverse reactions, especially in frail elderly with comorbidities.
Risk of contrast-induced acute kidney injury (CI-AKI), especially in patients with pre-existing renal impairment, diabetes, dehydration, or concurrent use of nephrotoxic drugs. Not for intrathecal use.
Not approved for intrathecal use; severe adverse reactions including seizures, coma, and death have occurred with inadvertent intrathecal administration.
["Hypersensitivity reactions (anaphylaxis, bronchospasm, angioedema)","Contrast-induced nephropathy","Thyroid storm in patients with hyperthyroidism","Cardiovascular effects (arrhythmias, hypotension, pulmonary edema)","Extravasation risk","Hematologic abnormalities (coagulopathy)","Interference with thyroid function tests","Sickle cell disease exacerbation"]
["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 leading to tissue necrosis","Sickle cell crisis in susceptible individuals","Interference with thyroid function tests"]
["History of severe hypersensitivity to iodinated contrast media","Manifest hyperthyroidism","Decompensated heart failure","Intrathecal administration (not indicated)","Anuria or severe renal impairment (relative, with caution)"]
["Known hypersensitivity to iopromide or any excipient","Manifest hyperthyroidism","Anuria or severe oliguria due to renal failure","Concurrent use of intrathecal corticosteroids"]
Data Pending Review
Data Pending Review
No specific food interactions; however, patients should maintain adequate hydration. Solid foods are generally not restricted, but some procedures may require fasting (e.g., 4-6 hours) per institutional protocol.
No specific food interactions. However, patients with phenylketonuria should be informed that ULTRAVIST 150 contains no phenylalanine. Avoid alcohol consumption before the procedure as it may affect hydration status.
ULTRAVIST (iopromide) is an iodinated contrast agent. In pregnancy, it crosses the placenta. First trimester: Inadvertent exposure is not associated with teratogenicity based on limited human data; animal studies show no evidence of fetal harm. Second and third trimesters: Fetal thyroid exposure can cause transient neonatal hypothyroidism; risk is dose-dependent.
ULTRAVIST 150 (iopromide) is a nonionic iodinated contrast medium. Animal studies have not shown teratogenic effects. In humans, the risk of fetal harm is considered low with standard diagnostic use. However, fetal hypothyroidism may occur if the agent crosses the placenta, particularly in the second and third trimesters, as iodine can affect fetal thyroid function. Transient neonatal hypothyroidism has been reported. The risk is dose-dependent and higher with repeated exposure. Generally, use is avoided in pregnancy unless essential, and if used, neonatal thyroid function should be assessed.
Iopromide is excreted into breast milk in very small amounts. The M/P ratio is approximately 1.0. The systemic dose to the infant is negligible (<0.01% of maternal dose). Breastfeeding can continue without interruption, but the infant should be monitored for rare hypersensitivity or gastrointestinal effects.
Iopromide is excreted into breast milk in very small amounts. The M/P ratio is unknown. The estimated infant dose is less than 1% of the maternal dose, which is considered clinically insignificant. Breastfeeding can be continued without interruption, although some guidelines suggest discontinuation for 24 hours as a precaution. The benefits of breastfeeding generally outweigh the negligible risk.
No pharmacokinetic changes in pregnancy require dose adjustments. Use the lowest necessary dose for diagnostic imaging. Contraindicated in known hypersensitivity to iodine-containing contrast agents.
No dose adjustment is required during pregnancy. Pharmacokinetic changes in pregnancy (increased plasma volume, renal blood flow, and GFR) may alter contrast clearance, but standard diagnostic doses remain appropriate. Use the lowest dose necessary to obtain diagnostic information. Ensure adequate hydration before and after administration.
Category C
Category C
Pre-warm contrast to body temperature to reduce viscosity and patient discomfort. Ensure adequate hydration (e.g., 100 mL/hour oral or IV fluids for 4-6 hours pre- and post-scan) to lower nephrotoxicity risk. Monitor serum creatinine and eGFR in patients with renal impairment; consider holding metformin for 48 hours post-contrast if eGFR <30 mL/min. Have resuscitation equipment available due to risk of anaphylactoid reactions, especially in patients with asthma or prior contrast allergy. Use lowest iodine dose necessary for diagnostic image quality.
ULTRAVIST 150 (iopromide) is a low-osmolar nonionic iodinated contrast medium. Pre-warming to 37°C reduces viscosity and improves tolerability. Monitor renal function before administration; hold metformin for 48h if eGFR <30 mL/min. Have emergency equipment ready for anaphylactoid reactions. For pediatric dosing, adjust volume based on body weight and imaging protocol.
Inform your healthcare provider if you have ever had an allergic reaction to contrast dye, iodine, or any medications.Drink plenty of water before and after the procedure unless instructed otherwise by your doctor.Tell your doctor if you are pregnant, breastfeeding, or have kidney disease, diabetes, or asthma.You may feel a warm sensation or metallic taste during injection; this is normal and usually temporary.Report any symptoms like hives, itching, difficulty breathing, or swelling of the face/throat immediately.
Inform your healthcare provider if you have kidney disease, diabetes, or are on metformin.Drink plenty of fluids before and after the procedure to help your kidneys eliminate the contrast.You may feel a warm sensation or a metallic taste during injection; this is common and temporary.Report any skin rash, breathing difficulty, or swelling of the face/throat immediately.If you have a history of allergic reactions to contrast, you may need premedication.