OSMOVIST 190

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OSMOVIST 190 (OSMOVIST 190).

How it works

Iodinated contrast media with high osmolality, providing radiographic contrast by attenuating X-rays, primarily due to iodine content.

What the body does with it

Metabolism	Not metabolized; excreted unchanged by glomerular filtration.
Excretion	Primarily renal (glomerular filtration). Excreted unchanged in urine, with less than 2% biliary/fecal excretion.
Half-life	Terminal elimination half-life approximately 110 minutes. In renal impairment, half-life is prolonged, requiring dose adjustment.
Protein binding	Negligible protein binding; less than 1% bound to plasma proteins.
Volume of Distribution	Approximately 0.28 L/kg, indicating distribution primarily in extracellular fluid.
Bioavailability	Intravenous route provides 100% bioavailability; non-IV routes (e.g., oral) not applicable or negligible.
Onset of Action	Immediate onset following IV or intra-arterial injection due to reaching contrast enhancement within seconds.
Duration of Action	Duration of contrast enhancement is brief, typically minutes, due to rapid distribution and elimination.

Classification & Brands

Dosing & administration

Intravenous administration of 0.1-0.3 mL/kg (0.19-0.57 mg iodine/kg) for adults; may repeat as needed. Maximum total dose 1.5 mL/kg.

Dosage form	INJECTABLE
Renal impairment	eGFR <30 mL/min/1.73 m²: use lowest effective dose, ensure adequate hydration, consider postponing procedure; eGFR <15: generally contraindicated unless necessary.
Liver impairment	No specific dose adjustment for Child-Pugh class; use lowest effective dose in severe impairment due to potential for altered contrast clearance.
Pediatric use	0.1-0.2 mL/kg intravenous, not to exceed 1.5 mL/kg total; individualize based on patient size and procedure.
Geriatric use	Use lowest effective dose; assess renal function (e.g., eGFR) prior to administration; ensure adequate hydration; 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 OSMOVIST 190 (OSMOVIST 190).

Breastfeeding	Iodinated contrast is excreted into breast milk in small amounts (M/P ratio <1). The estimated infant dose is <1% of maternal dose, considered clinically insignificant. Breastfeeding can continue without interruption; however, some guidelines recommend discarding milk for 12-24 hours post-procedure.
Teratogenic Risk	Iodinated contrast agents cross the placenta. First trimester exposure is associated with a theoretical risk of fetal thyroid suppression, but no definitive teratogenic effects have been established in humans. Second and third trimester exposure may cause transient neonatal hypothyroidism. The risk is low with single exposure.

Warnings & precautions

■ FDA Black Box Warning

Risk of serious adverse reactions including anaphylaxis, renal failure, and cardiovascular complications, especially in patients with history of allergy, asthma, or renal impairment.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Absolute: Known hypersensitivity to ioversol or any component, previous life-threatening reaction to iodinated contrast media.","Relative: Severe renal impairment (eGFR <30 mL/min), unstable cardiovascular status, pregnancy, and lactation."]

Clinical Precautions

Precautions

["Risk of contrast-induced nephropathy (CIN) in patients with pre-existing renal impairment, diabetes, dehydration, or concurrent nephrotoxic drugs.","Hypersensitivity reactions including anaphylaxis; premedication recommended in high-risk patients.","Severe cardiovascular effects including cardiac arrest, arrhythmias, and hypotension.","Electrolyte disturbances and fluid overload in patients with heart failure."]

Clinical Tips & Counseling

Drug interactions

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OSMOVIST 190

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OSMOVIST 190 (OSMOVIST 190).

How it works

Iodinated contrast media with high osmolality, providing radiographic contrast by attenuating X-rays, primarily due to iodine content.

What the body does with it

Metabolism	Not metabolized; excreted unchanged by glomerular filtration.
Excretion	Primarily renal (glomerular filtration). Excreted unchanged in urine, with less than 2% biliary/fecal excretion.
Half-life	Terminal elimination half-life approximately 110 minutes. In renal impairment, half-life is prolonged, requiring dose adjustment.
Protein binding	Negligible protein binding; less than 1% bound to plasma proteins.
Volume of Distribution	Approximately 0.28 L/kg, indicating distribution primarily in extracellular fluid.
Bioavailability	Intravenous route provides 100% bioavailability; non-IV routes (e.g., oral) not applicable or negligible.
Onset of Action	Immediate onset following IV or intra-arterial injection due to reaching contrast enhancement within seconds.
Duration of Action	Duration of contrast enhancement is brief, typically minutes, due to rapid distribution and elimination.

Classification & Brands

Dosing & administration

Intravenous administration of 0.1-0.3 mL/kg (0.19-0.57 mg iodine/kg) for adults; may repeat as needed. Maximum total dose 1.5 mL/kg.

Dosage form	INJECTABLE
Renal impairment	eGFR <30 mL/min/1.73 m²: use lowest effective dose, ensure adequate hydration, consider postponing procedure; eGFR <15: generally contraindicated unless necessary.
Liver impairment	No specific dose adjustment for Child-Pugh class; use lowest effective dose in severe impairment due to potential for altered contrast clearance.
Pediatric use	0.1-0.2 mL/kg intravenous, not to exceed 1.5 mL/kg total; individualize based on patient size and procedure.
Geriatric use	Use lowest effective dose; assess renal function (e.g., eGFR) prior to administration; ensure adequate hydration; 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 OSMOVIST 190 (OSMOVIST 190).

Breastfeeding	Iodinated contrast is excreted into breast milk in small amounts (M/P ratio <1). The estimated infant dose is <1% of maternal dose, considered clinically insignificant. Breastfeeding can continue without interruption; however, some guidelines recommend discarding milk for 12-24 hours post-procedure.
Teratogenic Risk	Iodinated contrast agents cross the placenta. First trimester exposure is associated with a theoretical risk of fetal thyroid suppression, but no definitive teratogenic effects have been established in humans. Second and third trimester exposure may cause transient neonatal hypothyroidism. The risk is low with single exposure.

Warnings & precautions

■ FDA Black Box Warning

Risk of serious adverse reactions including anaphylaxis, renal failure, and cardiovascular complications, especially in patients with history of allergy, asthma, or renal impairment.