OMNIPAQUE 70
Clinical safety rating: caution
Comprehensive clinical and safety monograph for OMNIPAQUE 70 (OMNIPAQUE 70).
Iodinated contrast agent that attenuates X-rays, enhancing vascular and tissue contrast by increasing the density of blood vessels and organs.
| Metabolism | Not metabolized; excreted unchanged by glomerular filtration. |
| Excretion | Renal: 100% unchanged via glomerular filtration. No biliary or fecal elimination. |
| Half-life | Terminal elimination half-life: 1-2 hours in normal renal function; prolonged in renal impairment (up to 20-30 hours in severe dysfunction). |
| Protein binding | None (negligible; <1% bound to plasma proteins). |
| Volume of Distribution | 0.3-0.5 L/kg (primarily extracellular fluid; does not cross intact blood-brain barrier). |
| Bioavailability | Intravenous: 100%. Oral: <0.1% (minimal absorption; not clinically significant). |
| Onset of Action | Intravenous: within minutes for contrast enhancement; oral/rectal: not applicable (non-absorbed for GI studies). |
| Duration of Action | Intravenous: 1-2 hours for contrast enhancement; prolonged in renal impairment. Clinical note: imaging should be performed within 30-60 minutes for optimal effect. |
1.5-2.0 mL/kg IV for contrast enhanced CT, max 150 mL; intra-arterial: 5-40 mL per injection depending on procedure.
| Dosage form | SOLUTION |
| Renal impairment | GFR >60: no adjustment; GFR 30-60: reduce dose by 50%; GFR <30: avoid use unless necessary with minimum dose and hemodialysis post-procedure. |
| Liver impairment | No specific dose adjustment required for hepatic impairment; monitor coagulation status if severe. |
| Pediatric use | 1.0-2.0 mL/kg IV for CT, max 3 mL/kg; not to exceed adult dose. |
| Geriatric use | Use lowest effective dose; ensure adequate hydration pre and post procedure; monitor renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for OMNIPAQUE 70 (OMNIPAQUE 70).
| Breastfeeding | Excreted into breast milk in minimal amounts; M/P ratio unknown; risk of neonatal hypothyroidism is theoretical; generally considered compatible with breastfeeding; interruption for 12-24 hours is optional. |
| Teratogenic Risk | No evidence of teratogenicity in animal studies; iodine-containing contrast agents cross the placenta; risk of fetal hypothyroidism with prolonged exposure or high doses; generally considered low risk for single diagnostic exposure. |
| Fetal Monitoring |
■ FDA Black Box Warning
Risk of contrast-induced acute kidney injury (CI-AKI) in patients with pre-existing renal insufficiency, diabetes, or dehydration.
| Serious Effects |
["Known hypersensitivity to iohexol or any component of the formulation","Severe renal impairment (eGFR <30 mL/min/1.73 m²) unless dialysis is planned","Concurrent administration of metformin in patients with or at risk for acute kidney injury"]
| Precautions | ["Severe hypersensitivity reactions including anaphylaxis may occur, especially in patients with history of prior reaction to iodinated contrast.","Thyroid storm in patients with hyperthyroidism or thyroid nodules.","Extravasation of contrast may cause tissue necrosis and compartment syndrome.","Patients with cardiovascular disease are at increased risk for hemodynamic instability.","Pregnancy: Use only if clearly needed; crosses placenta."] |
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| Monitor maternal renal function before administration; assess fetal thyroid function if high doses or repeated exposures occurred; observe for maternal allergic reactions; ensure adequate hydration. |
| Fertility Effects | No known adverse effects on fertility in animals or humans. |