OSMOVIST 240

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OSMOVIST 240 (OSMOVIST 240).

How it works

Nonionic iodinated contrast medium that attenuates X-rays is excreted unchanged in urine; increases density of blood vessels and tissues to enhance radiological visualization.

What the body does with it

Metabolism	Not metabolized; excreted unchanged by glomerular filtration.
Excretion	Primarily renal (glomerular filtration); >95% of administered dose excreted unchanged in urine within 24 hours. Negligible biliary/fecal elimination (<5%).
Half-life	Terminal elimination half-life approximately 2 hours (range 1.5–4 hours) in patients with normal renal function; prolonged in renal impairment proportional to creatinine clearance.
Protein binding	Negligible protein binding (<5%); primarily binds to plasma proteins such as albumin with low affinity.
Volume of Distribution	Approximately 0.26 L/kg, indicating distribution predominantly in extracellular fluid space.
Bioavailability	100% via intravenous administration; not absorbed orally (no oral bioavailability).
Onset of Action	Immediately upon intravenous injection; enhancement of vasculature visible within seconds during dynamic imaging.
Duration of Action	Sufficient for contrast-enhanced imaging procedures (e.g., CT, angiography) lasting 30–60 minutes; repeated dosing may be required for multiphase studies.

Classification & Brands

Dosing & administration

Intravenous bolus injection: 0.5 mL/kg to 1 mL/kg of Osnovist 240 (240 mg iodine/mL) for CT enhancement, up to a maximum of 150 mL per dose.

Dosage form	INJECTABLE
Renal impairment	If eGFR < 30 mL/min/1.73m², avoid use unless essential; if used, consider lowest diagnostic dose (e.g., 0.5 mL/kg) and ensure adequate hydration. No formal dose reduction guidelines exist; use with caution in moderate renal impairment (eGFR 30–59 mL/min/1.73m²).
Liver impairment	No specific Child-Pugh based adjustments are established. Use standard dose with caution in severe hepatic impairment due to potential decreased drug clearance.
Pediatric use	Body weight 0.5–1.5 mL/kg (240 mg iodine/mL) intravenously, up to a maximum of 2 mL/kg or 150 mL, based on clinical indication.
Geriatric use	No specific dose adjustment is recommended for elderly patients; however, assess renal function (eGFR) prior to administration, and use the lowest effective dose with adequate hydration due to higher 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 240 (OSMOVIST 240).

Breastfeeding	Very small amounts (<1% of maternal dose) excreted into breast milk. M/P ratio not established. Risk to infant negligible; however, temporary cessation of breastfeeding for 12-24 hours is recommended to minimize any theoretical risk.
Teratogenic Risk	Iodinated contrast media cross the placenta. There is no evidence of teratogenicity in humans; however, fetal thyroid function may be transiently suppressed, especially in the third trimester. Use only if clearly needed.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

Not for intrathecal use; inadvertent intrathecal administration may cause death, convulsions, cerebral hemorrhage, coma, paralysis, arachnoiditis, acute renal failure, cardiac arrest, seizures, rhabdomyolysis, hyperthermia, and brain edema.

Side Effect Profile

Serious Effects

Absolute Contraindications

Known hypersensitivity to ioversol or any component; history of anaphylaxis to iodinated contrast media; patients with multiple myeloma, pheochromocytoma, or homozygous sickle cell disease (relative).

Clinical Precautions

Precautions

Risk of serious delayed reactions (e.g., fever, rash, flu-like symptoms), nephrotoxicity, anaphylactoid reactions, contrast-induced acute kidney injury (CI-AKI), extravasation causing tissue necrosis, thyrotoxic crisis in patients with hyperthyroidism, sickle cell disease crises, and interference with thyroid function tests.

Clinical Tips & Counseling

Drug interactions

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OSMOVIST 240

Clinical safety rating: caution

Comprehensive clinical and safety monograph for OSMOVIST 240 (OSMOVIST 240).

How it works

Nonionic iodinated contrast medium that attenuates X-rays is excreted unchanged in urine; increases density of blood vessels and tissues to enhance radiological visualization.

What the body does with it

Metabolism	Not metabolized; excreted unchanged by glomerular filtration.
Excretion	Primarily renal (glomerular filtration); >95% of administered dose excreted unchanged in urine within 24 hours. Negligible biliary/fecal elimination (<5%).
Half-life	Terminal elimination half-life approximately 2 hours (range 1.5–4 hours) in patients with normal renal function; prolonged in renal impairment proportional to creatinine clearance.
Protein binding	Negligible protein binding (<5%); primarily binds to plasma proteins such as albumin with low affinity.
Volume of Distribution	Approximately 0.26 L/kg, indicating distribution predominantly in extracellular fluid space.
Bioavailability	100% via intravenous administration; not absorbed orally (no oral bioavailability).
Onset of Action	Immediately upon intravenous injection; enhancement of vasculature visible within seconds during dynamic imaging.
Duration of Action	Sufficient for contrast-enhanced imaging procedures (e.g., CT, angiography) lasting 30–60 minutes; repeated dosing may be required for multiphase studies.

Classification & Brands

Dosing & administration

Intravenous bolus injection: 0.5 mL/kg to 1 mL/kg of Osnovist 240 (240 mg iodine/mL) for CT enhancement, up to a maximum of 150 mL per dose.

Dosage form	INJECTABLE
Renal impairment	If eGFR < 30 mL/min/1.73m², avoid use unless essential; if used, consider lowest diagnostic dose (e.g., 0.5 mL/kg) and ensure adequate hydration. No formal dose reduction guidelines exist; use with caution in moderate renal impairment (eGFR 30–59 mL/min/1.73m²).
Liver impairment	No specific Child-Pugh based adjustments are established. Use standard dose with caution in severe hepatic impairment due to potential decreased drug clearance.
Pediatric use	Body weight 0.5–1.5 mL/kg (240 mg iodine/mL) intravenously, up to a maximum of 2 mL/kg or 150 mL, based on clinical indication.
Geriatric use	No specific dose adjustment is recommended for elderly patients; however, assess renal function (eGFR) prior to administration, and use the lowest effective dose with adequate hydration due to higher 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 240 (OSMOVIST 240).

Breastfeeding	Very small amounts (<1% of maternal dose) excreted into breast milk. M/P ratio not established. Risk to infant negligible; however, temporary cessation of breastfeeding for 12-24 hours is recommended to minimize any theoretical risk.
Teratogenic Risk	Iodinated contrast media cross the placenta. There is no evidence of teratogenicity in humans; however, fetal thyroid function may be transiently suppressed, especially in the third trimester. Use only if clearly needed.
Fetal Monitoring