CONRAY 30
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CONRAY 30 (CONRAY 30).
Iothalamate meglumine is a water-soluble iodinated radiographic contrast agent that attenuates X-rays, providing vascular and organ opacification. It distributes in the extracellular fluid and is excreted unchanged by glomerular filtration.
| Metabolism | Not metabolized; excreted unchanged by glomerular filtration. |
| Excretion | Renal (90-100% unchanged via glomerular filtration within 24 hours); minimal biliary/fecal (<1%) |
| Half-life | Terminal elimination half-life: 1.5-2 hours (normal renal function); prolonged to 20-40 hours in severe renal impairment (CrCl <30 mL/min) |
| Protein binding | Minimal (approximately 10% bound to serum albumin at therapeutic concentrations) |
| Volume of Distribution | 0.2-0.3 L/kg (primarily confined to extracellular fluid space; minimal intracellular penetration) |
| Bioavailability | IV: 100%; Oral: negligible (not absorbed); other routes: not applicable |
| Onset of Action | IV: immediate (within seconds; vascular opacification); Intra-arterial: immediate; Oral/Other routes: not applicable (only approved for intravascular use) |
| Duration of Action | IV: sufficient for diagnostic imaging (15-30 minutes for contrast enhancement); complete elimination within 24 hours in normal renal function |
Intravenous: 50-300 mL of a 30% solution (150-900 mg iodine/kg) as a single dose for contrast enhancement. Dosing depends on procedure and patient weight.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in patients with severe renal impairment (eGFR <30 mL/min/1.73m²). For moderate impairment (eGFR 30-59 mL/min/1.73m²), use lowest necessary dose and ensure adequate hydration. No specific dose reduction formula established. |
| Liver impairment | No specific adjustments for Child-Pugh class A or B. For severe hepatic impairment (Child-Pugh class C), use with caution due to increased risk of adverse reactions; consider lowest feasible dose. |
| Pediatric use | Intravenous: 1-3 mL/kg (150-450 mg iodine/kg) as a single dose. Maximum total dose not to exceed 5 mL/kg (750 mg iodine/kg) based on procedure and institutional protocols. |
| Geriatric use | No specific dose adjustment required, but higher risk of contrast-induced nephropathy. Assess renal function (eGFR) and hydration status. Use lowest necessary dose. Avoid use in elderly with eGFR <30 mL/min/1.73m². |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for CONRAY 30 (CONRAY 30).
| Breastfeeding | Iothalamate is excreted into breast milk in very small amounts (M/P ratio unknown, but estimated <1% of maternal dose). The risk to the nursing infant is negligible. However, due to the theoretical risk of hypothyroidism from free iodide, it is recommended to temporarily discontinue breastfeeding for 12-24 hours after administration and pump and discard milk during that period. |
| Teratogenic Risk | Conray 30 (iothalamate meglumine 30%) is an ionic iodinated contrast agent. In vitro and animal studies have shown no teratogenic effects. Direct fetal exposure during pregnancy is minimal as the drug does not cross the placenta in significant amounts. However, theoretical risk of fetal hypothyroidism exists due to free iodide release. First trimester: avoid unless essential. Second and third trimesters: use only if diagnostic benefit outweighs potential risks, with neonatal thyroid function monitoring recommended. |
■ FDA Black Box Warning
Risk of serious adverse reactions including anaphylaxis, cardiovascular collapse, and renal failure. Not for intrathecal use.
| Serious Effects |
["Hypersensitivity to iothalamate or any component","Anuria or severe renal impairment (contraindicated for certain procedures)","Intrathecal administration (contraindicated due to neurotoxicity)"]
| Precautions | ["Hypersensitivity reactions (anaphylaxis, bronchospasm, laryngeal edema)","Contrast-induced nephropathy (increased risk with pre-existing renal impairment, diabetes, dehydration)","Cardiovascular adverse effects (arrhythmias, hypotension, cardiac arrest)","Thyroid dysfunction (thyroid storm in patients with hyperthyroidism)","Extravasation risk (tissue necrosis)"] |
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| Fetal Monitoring | Maternal: Monitor for hypersensitivity reactions (e.g., urticaria, bronchospasm, anaphylaxis) and acute kidney injury (serum creatinine, urine output). Fetal: No specific fetal monitoring required during administration; however, neonatal thyroid function tests (TSH, T4) are recommended if contrast was given in the second or third trimester due to risk of transient hypothyroidism. |
| Fertility Effects | No known adverse effects on human fertility. Animal studies have not demonstrated impairment of fertility. |