DIONOSIL OILY

Clinical safety rating: caution

Comprehensive clinical and safety monograph for DIONOSIL OILY (DIONOSIL OILY).

How it works

DIONOSIL OILY is a radiographic contrast agent containing propyliodone, which is an iodine-containing compound that absorbs X-rays, thereby enhancing the visualization of body structures during imaging procedures.

What the body does with it

Metabolism	Propyliodone is metabolized in the liver via deiodination and conjugation, with metabolites excreted in urine.
Excretion	Primarily renal excretion of the water-soluble metabolite (propiodone) after hepatic deiodination; approximately 60-80% of the administered iodine is excreted in urine within 48 hours. Fecal excretion is negligible (<5%).
Half-life	Terminal elimination half-life of the iodine moiety is approximately 60 days due to slow release from fatty tissues. This long half-life reflects the persistence of the oily vehicle and slow deiodination, necessitating monitoring for cumulative iodine effects.
Protein binding	Negligible binding to plasma proteins; the parent compound is highly lipophilic and predominantly distributed in adipose tissue and lipid-rich environments.
Volume of Distribution	Apparent volume of distribution is approximately 5-10 L/kg, indicating extensive sequestration in adipose tissue and slow redistribution.
Bioavailability	Not applicable for oral route; administered only via intratracheal instillation. Absorption from the respiratory tract is minimal; local retention is the intended effect.
Onset of Action	Onset of bronchographic effect is immediate upon intratracheal instillation; coating of bronchial mucosa occurs within seconds to minutes.
Duration of Action	Duration of radiographic contrast effect is 3-5 days due to slow clearance of the oily vehicle. Residual oil may persist in alveoli for weeks, with potential for granuloma formation.

Classification & Brands

Dosing & administration

Adults: 10 mL intraurethral instillation as a sterile oily suspension (50% w/v) once daily for 3-5 days.

Dosage form	SUSPENSION
Renal impairment	No specific recommendations; contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m²) due to potential propyliodone accumulation.
Liver impairment	Child-Pugh A: No adjustment. Child-Pugh B or C: Use with caution due to limited data; monitor for adverse effects.
Pediatric use	Not recommended for children due to lack of safety and efficacy data.
Geriatric use	No specific dose adjustment; use with caution due to increased risk of prostatic hypertrophy and urinary retention.

Use during pregnancy

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

Clinical note

Comprehensive clinical and safety monograph for DIONOSIL OILY (DIONOSIL OILY).

Breastfeeding	No specific data on propyliodone excretion in breast milk. Iodinated contrast agents are expected to transfer minimally. The milk-to-plasma ratio is unknown. Caution advised; consider discontinuing breastfeeding for 24 hours after administration.
Teratogenic Risk	Dionosil Oily (propyliodone) is an iodinated contrast agent. In the first trimester, theoretical risk of fetal thyroid dysfunction due to iodine overload. Second and third trimesters: no known teratogenic effects, but transient neonatal hypothyroidism has been reported with other iodinated contrast agents. Avoid use unless essential.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Hypersensitivity to propyliodone or any component","Severe pulmonary hypertension","Active pulmonary hemorrhage"]

Clinical Precautions

Precautions

["Risk of hypersensitivity reactions including anaphylaxis","Caution in patients with history of asthma or allergies","Potential for bronchospasm during bronchography","Avoid extravasation as it may cause tissue irritation"]

Clinical Tips & Counseling

Drug interactions

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DIONOSIL OILY

Clinical safety rating: caution

Comprehensive clinical and safety monograph for DIONOSIL OILY (DIONOSIL OILY).

How it works

What the body does with it

Metabolism	Propyliodone is metabolized in the liver via deiodination and conjugation, with metabolites excreted in urine.
Excretion	Primarily renal excretion of the water-soluble metabolite (propiodone) after hepatic deiodination; approximately 60-80% of the administered iodine is excreted in urine within 48 hours. Fecal excretion is negligible (<5%).
Half-life	Terminal elimination half-life of the iodine moiety is approximately 60 days due to slow release from fatty tissues. This long half-life reflects the persistence of the oily vehicle and slow deiodination, necessitating monitoring for cumulative iodine effects.
Protein binding	Negligible binding to plasma proteins; the parent compound is highly lipophilic and predominantly distributed in adipose tissue and lipid-rich environments.
Volume of Distribution	Apparent volume of distribution is approximately 5-10 L/kg, indicating extensive sequestration in adipose tissue and slow redistribution.
Bioavailability	Not applicable for oral route; administered only via intratracheal instillation. Absorption from the respiratory tract is minimal; local retention is the intended effect.
Onset of Action	Onset of bronchographic effect is immediate upon intratracheal instillation; coating of bronchial mucosa occurs within seconds to minutes.
Duration of Action	Duration of radiographic contrast effect is 3-5 days due to slow clearance of the oily vehicle. Residual oil may persist in alveoli for weeks, with potential for granuloma formation.

Classification & Brands

Dosing & administration

Adults: 10 mL intraurethral instillation as a sterile oily suspension (50% w/v) once daily for 3-5 days.

Dosage form	SUSPENSION
Renal impairment	No specific recommendations; contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m²) due to potential propyliodone accumulation.
Liver impairment	Child-Pugh A: No adjustment. Child-Pugh B or C: Use with caution due to limited data; monitor for adverse effects.
Pediatric use	Not recommended for children due to lack of safety and efficacy data.
Geriatric use	No specific dose adjustment; use with caution due to increased risk of prostatic hypertrophy and urinary retention.

Use during pregnancy

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

Clinical note

Comprehensive clinical and safety monograph for DIONOSIL OILY (DIONOSIL OILY).

Breastfeeding	No specific data on propyliodone excretion in breast milk. Iodinated contrast agents are expected to transfer minimally. The milk-to-plasma ratio is unknown. Caution advised; consider discontinuing breastfeeding for 24 hours after administration.
Teratogenic Risk	Dionosil Oily (propyliodone) is an iodinated contrast agent. In the first trimester, theoretical risk of fetal thyroid dysfunction due to iodine overload. Second and third trimesters: no known teratogenic effects, but transient neonatal hypothyroidism has been reported with other iodinated contrast agents. Avoid use unless essential.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Hypersensitivity to propyliodone or any component","Severe pulmonary hypertension","Active pulmonary hemorrhage"]