CONRAY 400

Clinical safety rating: caution

Comprehensive clinical and safety monograph for CONRAY 400 (CONRAY 400).

How it works

Iodinated radiocontrast agent that attenuates X-rays by blocking their passage, thereby enhancing radiographic contrast in imaging procedures.

What the body does with it

Metabolism	Primarily eliminated unchanged via renal glomerular filtration; minimal hepatic metabolism.
Excretion	Primarily renal: >95% of administered dose excreted unchanged in urine within 24 hours. Biliary/fecal excretion: negligible (<1%).
Half-life	Terminal elimination half-life is approximately 1.5-2 hours in patients with normal renal function. In patients with renal impairment, half-life may be prolonged significantly.
Protein binding	Minimal protein binding: ~1-2% primarily to albumin.
Volume of Distribution	Volume of distribution (Vd): approximately 0.25-0.3 L/kg, approximating the extracellular fluid volume.
Bioavailability	Intravenous administration: 100% (complete bioavailability). No oral or other routes are clinically relevant.
Onset of Action	Intravenous injection: immediate (seconds to minutes) as contrast reaches the vasculature. Intra-arterial injection: instantaneous.
Duration of Action	Duration of diagnostic enhancement: typically 15-30 minutes for CT imaging; complete elimination from the body within 24 hours in patients with normal renal function.

Classification & Brands

Dosing & administration

0.5-1.0 mL/kg (up to 150 mL total) intravenously, maximum 150 mL per procedure.

Dosage form	INJECTABLE
Renal impairment	No specific dose adjustment for GFR; contraindicated if eGFR < 30 mL/min/1.73m²; in patients with eGFR 30-44 mL/min/1.73m², use lowest effective dose and ensure adequate hydration.
Liver impairment	No specific dose adjustment based on Child-Pugh score; use with caution in severe hepatic impairment due to potential for prolonged circulation.
Pediatric use	0.5-1.0 mL/kg (maximum 150 mL) intravenously, administered according to same protocol as adults.
Geriatric use	Use lowest effective dose; assess renal function (eGFR) prior to administration; ensure adequate hydration due to increased risk of contrast-induced nephropathy.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for CONRAY 400 (CONRAY 400).

Breastfeeding	Contrast agent is negligibly excreted into breast milk; M/P ratio not established. American College of Radiology states no need to interrupt breastfeeding. If concerned, pump and discard for 24 h.
Teratogenic Risk	Category D: Iodinated contrast agents cross the placenta. Risk of fetal hypothyroidism, especially in the first trimester. Limited studies, but theoretical risk. Use only if clearly needed.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

WARNING: RISK OF CONTRAST-INDUCED NEPHROPATHY (CIN) IN PATIENTS WITH RENAL IMPAIRMENT OR DIABETES MELLITUS. Patients with pre-existing renal insufficiency, particularly those with diabetes, are at high risk for acute renal failure following administration. Appropriate hydration and monitoring of renal function are essential.

Side Effect Profile

Serious Effects

Absolute Contraindications

Absolute: History of anaphylactic reaction to iodinated contrast media. Relative: Renal impairment (eGFR <30 mL/min), diabetes mellitus, concurrent use of nephrotoxic drugs, thyroid storm risk.

Clinical Precautions

Precautions

Risk of acute renal failure, especially in patients with renal impairment or diabetes. Severe allergic-type reactions including anaphylaxis and bronchospasm. Thyroid dysfunction risk in patients with hyperthyroidism or thyroid neoplasms. Cardiovascular adverse effects such as arrhythmias and hypotension. Use caution in patients with heart failure, multiple myeloma, pheochromocytoma, and sickle cell disease.

Clinical Tips & Counseling

Drug interactions

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CONRAY 400

Clinical safety rating: caution

Comprehensive clinical and safety monograph for CONRAY 400 (CONRAY 400).

How it works

Iodinated radiocontrast agent that attenuates X-rays by blocking their passage, thereby enhancing radiographic contrast in imaging procedures.

What the body does with it

Metabolism	Primarily eliminated unchanged via renal glomerular filtration; minimal hepatic metabolism.
Excretion	Primarily renal: >95% of administered dose excreted unchanged in urine within 24 hours. Biliary/fecal excretion: negligible (<1%).
Half-life	Terminal elimination half-life is approximately 1.5-2 hours in patients with normal renal function. In patients with renal impairment, half-life may be prolonged significantly.
Protein binding	Minimal protein binding: ~1-2% primarily to albumin.
Volume of Distribution	Volume of distribution (Vd): approximately 0.25-0.3 L/kg, approximating the extracellular fluid volume.
Bioavailability	Intravenous administration: 100% (complete bioavailability). No oral or other routes are clinically relevant.
Onset of Action	Intravenous injection: immediate (seconds to minutes) as contrast reaches the vasculature. Intra-arterial injection: instantaneous.
Duration of Action	Duration of diagnostic enhancement: typically 15-30 minutes for CT imaging; complete elimination from the body within 24 hours in patients with normal renal function.

Classification & Brands

Dosing & administration

0.5-1.0 mL/kg (up to 150 mL total) intravenously, maximum 150 mL per procedure.

Dosage form	INJECTABLE
Renal impairment	No specific dose adjustment for GFR; contraindicated if eGFR < 30 mL/min/1.73m²; in patients with eGFR 30-44 mL/min/1.73m², use lowest effective dose and ensure adequate hydration.
Liver impairment	No specific dose adjustment based on Child-Pugh score; use with caution in severe hepatic impairment due to potential for prolonged circulation.
Pediatric use	0.5-1.0 mL/kg (maximum 150 mL) intravenously, administered according to same protocol as adults.
Geriatric use	Use lowest effective dose; assess renal function (eGFR) prior to administration; ensure adequate hydration due to increased risk of contrast-induced nephropathy.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for CONRAY 400 (CONRAY 400).

Breastfeeding	Contrast agent is negligibly excreted into breast milk; M/P ratio not established. American College of Radiology states no need to interrupt breastfeeding. If concerned, pump and discard for 24 h.
Teratogenic Risk	Category D: Iodinated contrast agents cross the placenta. Risk of fetal hypothyroidism, especially in the first trimester. Limited studies, but theoretical risk. Use only if clearly needed.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

Side Effect Profile

Serious Effects

Absolute Contraindications

Absolute: History of anaphylactic reaction to iodinated contrast media. Relative: Renal impairment (eGFR <30 mL/min), diabetes mellitus, concurrent use of nephrotoxic drugs, thyroid storm risk.