Comparative Pharmacology
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 240.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 240.
ULTRAVIST (PHARMACY BULK) vs ULTRAVIST 240
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.
Iodinated nonionic contrast agent that attenuates X-rays by increasing the density of iodine atoms, enhancing vascular and tissue contrast during imaging procedures. It does not have intrinsic pharmacological activity.
Coronary angiography and ventriculographyPeripheral angiographyVisceral angiographyAortographyCerebral angiographyIntravenous urographyComputed tomography enhancementDigital subtraction angiography
Intravascular imaging: CT, angiography, urographyIntrathecal administration: CT myelography, lumbar myelographyOff-label: Coronary angiography, peripheral angiography
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.
IV injection: 1.0-2.0 mL/kg (240 mg I/mL) for CT; total dose not to exceed 250 mL per procedure.
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 is approximately 2 hours in patients with normal renal function. In patients with renal impairment, half-life may be prolonged up to 10-30 hours, necessitating dose adjustment.
Not metabolized; eliminated unchanged via glomerular filtration.
Not metabolized; eliminated unchanged via renal glomerular filtration in patients with normal renal function. No hepatic involvement.
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 excretion via glomerular filtration; approximately >90% of the administered dose is excreted unchanged in the urine within 24 hours. Biliary/fecal excretion is negligible (<2%).
Low; approximately 10-15% bound to plasma proteins, mainly albumin.
Minimal binding; approximately 1-2% bound to plasma proteins (primarily albumin).
Approximately 0.2-0.3 L/kg, indicating distribution primarily in extracellular fluid.
Approximately 0.2-0.3 L/kg; predominantly confined to extracellular fluid and vascular space.
Not applicable for oral route; administered intravenously, bioavailability is 100%.
Intravenous administration: 100% (bioavailability not applicable for oral route as it is not absorbed orally).
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 mL/min/1.73m²: use lowest possible dose; consider alternative imaging. eGFR 30-44: ensure hydration, use minimum diagnostic dose. eGFR ≥45: no adjustment needed.
No specific dose adjustment recommended based on Child-Pugh class; use caution in severe hepatic impairment due to potential coagulation abnormalities.
No specific Child-Pugh based adjustment; use caution in severe hepatic impairment due to potential coagulation abnormalities.
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.
IV: 1.0-2.0 mL/kg (240 mg I/mL) based on age and imaging; maximum 3.0 mL/kg per procedure, not to exceed 250 mL.
Start with lower end of dosing range; monitor renal function (eGFR) and hydration status; increased risk of nephrotoxicity and volume overload.
Assess renal function (eGFR) and hydrate adequately; use lowest diagnostic dose due to increased risk of nephrotoxicity and dehydration.
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.
None listed by FDA (nonionic contrast agents may carry risk of contrast-induced nephropathy, but no boxed warning for ULTRAVIST 240 specifically).
["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"]
["Contrast-induced nephropathy risk, especially in preexisting renal impairment, diabetes, dehydration","Anaphylaxis risk; premedication recommended for high-risk patients","Thyroid toxicity in patients with hyperthyroidism or thyroid nodules","Severe cutaneous adverse reactions (SCARs)","CNS adverse effects with intrathecal use: seizures, cerebral edema"]
["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)"]
["Absolute: Known hypersensitivity to iodinated contrast agents, anuria/decompensated renal failure","Relative: Preexisting renal impairment (eGFR <30), concurrent use of nephrotoxic drugs, hyperthyroidism, pregnancy"]
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 are typically advised to avoid solid food for 4 hours before the procedure if sedation is planned. Maintain adequate hydration; no restrictions on clear liquids unless specified by the practitioner.
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 240 (iopromide) is an iodinated contrast agent. In pregnant women, exposure is generally avoided unless essential. Animal studies have not shown teratogenic effects, but adequate human studies are lacking. First trimester: theoretical risk of fetal thyroid suppression if large doses are used, but no structural teratogenicity documented. Second and third trimesters: consider fetal hypothyroidism risk due to free iodide; neonatal thyroid function monitoring recommended if exposure occurred.
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 small amounts; M/P ratio not established. Estimated infant dose <1% of maternal dose. Clinically insignificant risk of adverse effects. Breastfeeding can continue without interruption, but cautious approach advises pumping and discarding milk for 24-48 hours post-exposure if mother is concerned.
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 specific pharmacokinetic studies in pregnancy. However, increased plasma volume and renal blood flow in pregnancy may alter distribution and elimination; no standard dose adjustment recommended. Use lowest necessary dose. Contrast agents should be used only when diagnostic information cannot be obtained by other means (e.g., MRI without contrast).
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 240 (iopromide) is a low-osmolar, nonionic iodinated contrast medium used for angiography, CT, and urography. Pre-warm to body temperature to reduce viscosity and patient discomfort. Ensure adequate hydration pre- and post-procedure to minimize nephrotoxicity, especially in patients with renal impairment (eGFR < 30). Have emergency equipment ready for anaphylactoid reactions. For diabetic patients on metformin, discontinue 48 hours prior and resume after 48 hours if renal function stable. Consider prophylactic corticosteroids and antihistamines for high-risk patients (prior reaction, asthma, allergies). Use lowest diagnostic dose possible.
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 had a previous allergic reaction to contrast media, iodine, or shellfish.Drink plenty of fluids before and after the procedure to help protect your kidneys.If you take metformin for diabetes, you will need to stop it 48 hours before the procedure and restart only after your kidney function is checked.You may experience a warm sensation or metallic taste during injection; this is temporary.After the procedure, monitor for delayed allergic reactions such as rash, itching, or difficulty breathing, and seek immediate medical attention if these occur.