OMNIPAQUE 140

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OMNIPAQUE 140 (OMNIPAQUE 140).

How it works

Radiopaque contrast agent that attenuates X-rays due to iodine content, enhancing vascular and tissue visualization.

What the body does with it

Metabolism	Not metabolized; excreted unchanged via glomerular filtration in urine.
Excretion	Renal: >95% unchanged via glomerular filtration; biliary/fecal: negligible (<1%).
Half-life	Terminal elimination half-life: 1–2 hours; prolonged in renal impairment (up to 30–40 hours in severe dysfunction).
Protein binding	< 2% bound; negligible binding to plasma proteins.
Volume of Distribution	Vd: 0.2–0.3 L/kg; limited to extracellular space, minimal intracellular penetration.
Bioavailability	Intravenous: 100% (only route used); not absorbed orally due to high osmolality and radiocontrast nature.
Onset of Action	Intravenous: immediate (seconds to minutes) for contrast enhancement; intrathecal: 2–5 minutes for myelography.
Duration of Action	Intravenous: 30–60 minutes for diagnostic imaging; intrathecal: 1–2 hours due to slower clearance from CSF.

Classification & Brands

Dosing & administration

Intravascular: 50-200 mL (containing 7.0-28.0 g iodine) per procedure, administered intravenously as a bolus or infusion; dose depends on imaging modality and body region. Intrathecal: 6-15 mL (containing 0.84-2.1 g iodine) administered via lumbar puncture for myelography.

Dosage form	INJECTABLE
Renal impairment	eGFR 30-59 mL/min/1.73m2: No routine dose adjustment, ensure adequate hydration. eGFR <30 mL/min/1.73m2: Use lowest feasible dose, consider alternative imaging if possible; post-procedure monitoring for contrast-induced nephropathy recommended. Hemodialysis: Administer after dialysis if possible; no supplemental dose needed.
Liver impairment	No specific hepatic adjustment required; metabolism is minimal. Use caution in severe hepatic impairment due to potential renal co-morbidity.
Pediatric use	Intravascular: 1.0-2.0 mL/kg (140-280 mg I/kg) per injection, maximum total dose 4.0 mL/kg (560 mg I/kg) per procedure. Intrathecal: 0.5-1.0 mL (70-140 mg I) for children weighing <15 kg; 1.5-3.0 mL (210-420 mg I) for 15-40 kg; 3.0-6.0 mL (420-840 mg I) for >40 kg.
Geriatric use	No specific dose adjustment; increased risk of adverse reactions due to age-related renal impairment and dehydration. Ensure adequate hydration and use minimum necessary dose. Monitor renal function pre- and post-procedure.

Use during pregnancy

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

Clinical note

Comprehensive clinical and safety monograph for OMNIPAQUE 140 (OMNIPAQUE 140).

Breastfeeding	Excreted into breast milk in very low amounts (M/P ratio ~0.07). Oral bioavailability in infant is negligible; risk of adverse effects is low. American College of Radiology advises no need to interrupt breastfeeding.
Teratogenic Risk	Category B. Iodinated contrast agents cross the placenta. First trimester: theoretical risk of fetal hypothyroidism, but no definitive teratogenicity in humans. Second/third trimester: risk of transient neonatal hypothyroidism; no structural anomalies reported.

Warnings & precautions

■ FDA Black Box Warning

Risk of severe, life-threatening adverse reactions including anaphylaxis, cardiac arrest, and hypotension; especial caution in patients with history of reaction to contrast media, bronchial asthma, or allergies.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Absolute: Known hypersensitivity to iodinated contrast media","Absolute: Anuria due to contrast-induced nephropathy history","Relative: Decompensated heart failure, severe hypertension, or unstable angina","Relative: Pregnancy (use only if clearly needed)","Relative: Concurrent administration of nephrotoxic drugs"]

Clinical Precautions

Precautions

["Risk of contrast-induced nephropathy (CIN) in patients with pre-existing renal impairment, diabetes, or dehydration","Serious anaphylactic/hypersensitivity reactions may occur; have emergency equipment available","Increased risk in patients with multiple myeloma, pheochromocytoma, sickle cell disease, or hyperthyroidism","Intrathecal use may cause neurotoxicity including seizures, arachnoiditis, and meningitis","Avoid in patients with severe hepatic impairment due to risk of delayed clearance"]

Clinical Tips & Counseling

Drug interactions

Loading safety data…

OMNIPAQUE 140

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OMNIPAQUE 140 (OMNIPAQUE 140).

How it works

Radiopaque contrast agent that attenuates X-rays due to iodine content, enhancing vascular and tissue visualization.

What the body does with it

Metabolism	Not metabolized; excreted unchanged via glomerular filtration in urine.
Excretion	Renal: >95% unchanged via glomerular filtration; biliary/fecal: negligible (<1%).
Half-life	Terminal elimination half-life: 1–2 hours; prolonged in renal impairment (up to 30–40 hours in severe dysfunction).
Protein binding	< 2% bound; negligible binding to plasma proteins.
Volume of Distribution	Vd: 0.2–0.3 L/kg; limited to extracellular space, minimal intracellular penetration.
Bioavailability	Intravenous: 100% (only route used); not absorbed orally due to high osmolality and radiocontrast nature.
Onset of Action	Intravenous: immediate (seconds to minutes) for contrast enhancement; intrathecal: 2–5 minutes for myelography.
Duration of Action	Intravenous: 30–60 minutes for diagnostic imaging; intrathecal: 1–2 hours due to slower clearance from CSF.

Classification & Brands

Dosing & administration

Dosage form	INJECTABLE
Renal impairment	eGFR 30-59 mL/min/1.73m2: No routine dose adjustment, ensure adequate hydration. eGFR <30 mL/min/1.73m2: Use lowest feasible dose, consider alternative imaging if possible; post-procedure monitoring for contrast-induced nephropathy recommended. Hemodialysis: Administer after dialysis if possible; no supplemental dose needed.
Liver impairment	No specific hepatic adjustment required; metabolism is minimal. Use caution in severe hepatic impairment due to potential renal co-morbidity.
Pediatric use	Intravascular: 1.0-2.0 mL/kg (140-280 mg I/kg) per injection, maximum total dose 4.0 mL/kg (560 mg I/kg) per procedure. Intrathecal: 0.5-1.0 mL (70-140 mg I) for children weighing <15 kg; 1.5-3.0 mL (210-420 mg I) for 15-40 kg; 3.0-6.0 mL (420-840 mg I) for >40 kg.
Geriatric use	No specific dose adjustment; increased risk of adverse reactions due to age-related renal impairment and dehydration. Ensure adequate hydration and use minimum necessary dose. Monitor renal function pre- and post-procedure.

Use during pregnancy

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

Clinical note

Comprehensive clinical and safety monograph for OMNIPAQUE 140 (OMNIPAQUE 140).

Breastfeeding	Excreted into breast milk in very low amounts (M/P ratio ~0.07). Oral bioavailability in infant is negligible; risk of adverse effects is low. American College of Radiology advises no need to interrupt breastfeeding.
Teratogenic Risk	Category B. Iodinated contrast agents cross the placenta. First trimester: theoretical risk of fetal hypothyroidism, but no definitive teratogenicity in humans. Second/third trimester: risk of transient neonatal hypothyroidism; no structural anomalies reported.