OMNIPAQUE 180
Clinical safety rating: caution
Comprehensive clinical and safety monograph for OMNIPAQUE 180 (OMNIPAQUE 180).
Iodinated contrast agent that radiates X-rays due to high iodine content, attenuating X-ray beams and enhancing vascular/tissue contrast.
| Metabolism | Not metabolized; excreted unchanged primarily via glomerular filtration (renal). |
| Excretion | Renal: >95% unchanged by glomerular filtration within 24 hours; Biliary/Fecal: <5% |
| Half-life | Terminal elimination half-life: 1-2 hours in patients with normal renal function; prolonged in renal impairment (up to 30-40 hours in severe impairment) |
| Protein binding | Negligible: <2% bound to plasma proteins (primarily albumin) |
| Volume of Distribution | 0.26 L/kg (confined to extracellular fluid; does not cross intact blood-brain barrier) |
| Bioavailability | Intravenous: 100%; Oral: not applicable; Intrathecal: 100% (direct administration, systemic absorption minimal) |
| Onset of Action | Intravenous: immediate (seconds to minutes) for contrast enhancement |
| Duration of Action | Intravenous: 15-30 minutes for contrast enhancement; complete renal elimination within 24 hours |
Intravenous: 50-200 mL of 180 mgI/mL (9-36 g iodine) administered as a bolus or infusion, depending on imaging procedure and patient size; typical CT dose: 100-150 mL.
| Dosage form | SOLUTION |
| Renal impairment | GFR 30-60 mL/min: reduce dose by 50% or increase interdose interval; GFR <30 mL/min: contraindicated or use only if essential with minimal dose and ensure hydration. |
| Liver impairment | No specific adjustment required for Child-Pugh classification; use with caution in severe hepatic impairment due to potential risk of hepatorenal syndrome. |
| Pediatric use | 0.5-3.0 mL/kg (90-540 mgI/kg) intravenously, maximum 3.0 mL/kg per dose; adjust based on procedure and age. |
| Geriatric use | Use lowest effective dose; assess renal function and ensure adequate hydration; avoid dehydration and nephrotoxic agents. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for OMNIPAQUE 180 (OMNIPAQUE 180).
| Breastfeeding | Iohexol is excreted in human milk in low amounts (M/P ratio not well established). The oral bioavailability in infants is low, so risk is minimal. However, the manufacturer recommends discontinuing breastfeeding for 24 hours after administration to minimize any potential exposure. |
| Teratogenic Risk | Omnipaque 180 (iohexol) is a nonionic iodinated contrast medium. Animal studies have not shown teratogenic effects. In pregnant women, no adequate controlled studies exist. Due to the risk of fetal hypothyroidism from free iodide, especially after first trimester, use only if clearly needed. Avoid in first trimester if possible. |
■ FDA Black Box Warning
Not for intrathecal use with non-ionic contrast media due to risk of neurotoxicity; strictly follow approved formulations and routes.
| Serious Effects |
["History of severe anaphylactoid reaction to iodinated contrast media.","Overt thyrotoxicosis.","Intrathecal administration of formulations not approved for that route."]
| Precautions | ["Risk of contrast-induced acute kidney injury (CI-AKI) in patients with pre-existing renal impairment, diabetes, or dehydration.","Anaphylactoid reactions may occur; have resuscitation equipment available.","Thyroid dysfunction due to iodine load; caution in hyperthyroidism or thyroid nodules.","Intrathecal use may cause arachnoiditis or seizures; ensure proper patient selection."] |
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| Fetal Monitoring | Monitor maternal renal function and hydration status before and after administration. Assess for signs of allergic or anaphylactic reactions in mother. No specific fetal monitoring required, but consider fetal thyroid function follow-up if significant exposure occurred in utero. |
| Fertility Effects | No known direct effects on fertility. However, iodinated contrast media may cause transient changes in thyroid function tests, but fertility impact is unlikely. |