Comparative Pharmacology
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 300.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAVIST PHARMACY BULK versus ULTRAVIST 300.
ULTRAVIST (PHARMACY BULK) vs ULTRAVIST 300
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, providing vascular and tissue enhancement for imaging.
Coronary angiography and ventriculographyPeripheral angiographyVisceral angiographyAortographyCerebral angiographyIntravenous urographyComputed tomography enhancementDigital subtraction angiography
Intra-arterial digital subtraction angiographyComputed tomography (CT) of the head and bodyExcretory urographyVentriculographyArthrographyOff-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.
Intravenous: 1.0-2.0 mL/kg (300-600 mg iodine/kg) body weight; maximum 200 mL per procedure. Intra-arterial: varies by 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: 1.5-2 hours (normal renal function); prolonged in renal impairment (up to 10 hours in severe cases).
Not metabolized; eliminated unchanged via glomerular filtration.
Not metabolized; eliminated unchanged by the kidneys 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.
Renal: 95-100% as unchanged drug within 24 hours; biliary/fecal: <1%.
Low; approximately 10-15% bound to plasma proteins, mainly albumin.
<10% bound to plasma proteins (mainly albumin).
Approximately 0.2-0.3 L/kg, indicating distribution primarily in extracellular fluid.
0.25-0.3 L/kg (extracellular fluid space, no significant tissue binding).
Not applicable for oral route; administered intravenously, bioavailability is 100%.
Intravenous: 100%; oral: not administered orally; no oral bioavailability data; intra-arterial: effectively 100%.
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: limit to lowest necessary dose, ensure hydration. eGFR <30 mL/min: avoid use unless essential; consider alternative imaging. Hemodialysis: not removed; no specific dose adjustment.
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 for Child-Pugh class A, B, or C necessary; use caution in severe hepatic impairment due to potential coagulation disorders.
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.
Neonates to adolescents: 1.0-2.0 mL/kg (300-600 mg iodine/kg) IV; maximum 2.0 mL/kg per procedure. Ensure adequate hydration.
Start with lower end of dosing range; monitor renal function (eGFR) and hydration status; increased risk of nephrotoxicity and volume overload.
No specific dose adjustment; monitor renal function closely due to age-related decline in GFR. Ensure adequate hydration pre- and post-procedure.
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.
No FDA black box warning.
["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 contrast-induced nephropathy in patients with renal impairment","Anaphylactoid reactions including hypotension, bronchospasm, and angioedema","Thyroid storm in patients with hyperthyroidism or thyroid nodules","Severe cardiovascular reactions including arrest and arrhythmias","Extravasation causing tissue necrosis","Pregnancy Category B: Use only if clearly needed"]
["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 component","Anuria or severe renal impairment not on dialysis","Concurrent administration of interleukin-2 within 48 hours"]
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 dietary restrictions are required, but maintaining adequate hydration with water or clear fluids is recommended. Avoid diuretic beverages (e.g., coffee, tea, alcohol) before and after the procedure as they may exacerbate dehydration. There are no known drug-food interactions with iopromide.
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.
Pregnancy Category B. No evidence of teratogenicity in animal studies. In first trimester, theoretical risk of fetal hypothyroidism due to free iodide release. In second and third trimesters, risk of transient neonatal hypothyroidism if administered near term. Overall low teratogenic risk, but use only if clearly needed.
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.
Iodinated contrast media are excreted into breast milk in minimal amounts (M/P ratio approximately 0.01). Oral bioavailability in infant is low; negligible risk of adverse effects. The American College of Radiology states that breastfeeding may be continued without interruption after contrast administration, but some guidelines suggest discarding milk for 12-24 hours if mother prefers.
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 dose adjustment required for pregnancy. Standard adult dosing applies, but consider reduced glomerular filtration rate in late pregnancy; adjust dose if renal impairment present. Use lowest effective dose to minimize fetal exposure.
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.
Pre-warm contrast to body temperature to reduce viscosity and injection discomfort. Ensure adequate hydration (e.g., 1 L oral or IV fluids) before and after administration to prevent contrast-induced nephropathy. Screen for metformin use; withhold metformin for 48 hours post-procedure if eGFR < 30 mL/min/1.73 m². Have emergency equipment ready for immediate treatment of anaphylactoid reactions (epinephrine, antihistamines, corticosteroids). Use lowest possible dose to achieve diagnostic image, especially in patients with renal impairment or risk factors for adverse reactions.
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 a history of allergic reactions to contrast media, asthma, or allergies to iodine.You may experience a warm sensation, metallic taste, or mild nausea during the injection; these sensations are usually temporary.Drink plenty of fluids before and after the procedure to help protect your kidneys.Report any symptoms such as hives, difficulty breathing, swelling of the face or throat, or severe itching to a medical professional immediately.If you are taking metformin for diabetes, discuss with your doctor whether you should stop it temporarily (usually 48 hours after the procedure).For patients with kidney disease, the use of this contrast agent may carry a risk of further kidney injury; your doctor may perform blood tests to assess your kidney function before the test.