Indications
Diapac 350 Injection is used for:
Radiographic contrast medium for diagnostic procedures
Adult Dose
Intravascular
Angiocardiography: ventriculography, pulmonary arteriography, venography & studies of collaterol arteries
Ventriculography: 40 mL, range of 30-60 mL; may be repeated as needed, not to exceed 250 mL
Selective Coronary Arteriography: 5 mL. range 3-14 mL per injection
Aortic Root and Arch Study: 50 mL, range 20-75 mL, when used alone
Pulmonary Angiography: 1 mL/kg
Combined Angiographic Procedures: Multiple Procedures not to exceed 5 mL/kg or 250 mL
Aortography and Selective Arteriography
- Aorta: 50-80 mL
- Major branches incl celiac, mesenteric arteries: 30-60 mL
- Renal arteries: 5-15 mL; not to exceed 250 mL/Iohexol 350 when repeat injection indicated
Cerebral Arteriography: Common Carotid Artery: 6-12 mL
Internal Carotid Artery: 8-10 mL
External Carotid Artery: 6-9 mL
Vertebral Artery: 6-10 mL
CT Scanning of the Body
Head Imaging via injection: 70-150 mL (Iohexol 300); 80 mL (Iohexol 350)
Body Imaging via injection: 50-200 mL (Iohexol 300); 60-100 mL (Iohexol 350)
Digital Subtraction
Iohexol 350
Usual amount used for IV digital technique is 30-50 mL
Administer as bolus at 7.5-30 mL/sec using pressure injector
Excretory Urography
Iohexol 300/350: 200-350 mgI/kg body weight
Hysterosalpingography
Iohexol 300: 15-20 mL, but varies with anatomy and/or disease state
Child Dose
Intravascular
Iohexol 300/350
Angiocardiography: ventriculography, pulmonary arteriography, venography & studies of collaterol arteries
Ventriculography: Iohexol 350: 1.25 mL/kg, range 1-1.5 mL/kg; not to exceed 5 mL/kg or 250 mL, when multiple injections given
Iohexol 300: 1.75 mL/kg, range 1.5-2 mL/kg; not to exceed 6 mL/kg or 291 mL, when multiple injections given
Pulmonary Angiography: 1 mL/kg
Combined Angiographic Procedures - Multiple Procedures
-Iohexol 350: Not to exceed 5 mL/kg or 250 mL
-Iohexol 300: Not to exceed 6 mL/kg or 291 mL
Aortography and selective arteriography: 1 mL/kg single inj dose; not to exceed 5 mL/kg or 250 mL
CT Scanning of the Body
Head imaging: 1-2 mL/kg; not to exceed 35 gI Iohexol 300
Body imaging via injection: 50-200 mL (Iohexol 300); 60-100 mL (Iohexol 350)
Excretory Urography
Iohexol 300: 0.5-3 mL/kg of body weight
Infants/children: According to age and body weight
Usual dose: 1-1.5 mL/kg; not to exceed 3 mL/kg
Renal Dose
Administration
Contra Indications
Procedure-specific. Intrathecal: Myelography in significant local or systemic infection where bacteremia is likely; concurrent use with corticosteroids; repeat myelography in the event of technical failure (risk of overdosage). Hysterosalpingography: During menstrual period or when menstrual flow in imminent; presence of infection; pregnancy, 6 mth after termination of pregnancy or 30 days after conization or curettage.
Precautions
Asthma or a history of allergies (risk of anaphylactoid reactions is increased); compromised blood-brain barrier (severe neurotoxicity after intrathecal use); epilepsy and brain tumour (higher risk of convulsions); severe hepatic or renal impairment, diabetics with renal impairment, dehydration and others who may be at increased risk of renal failure; multiple myeloma (dehydration from use may cause precipitation of protein in the renal tubules, leading to anuria and fatal renal failure); severe hypertension; advanced cardiac disease; phaeochromocytoma; sickle-cell disease; hyperthyroidism; debilitated, severely ill, very old, or very young patients; occlusive vascular disease. Special care to ensure that 140 and 350 mg iodine/ml solutions are not given intrathecally. Adequate resuscitative facilities should be available when radiographic procedures are undertaken, and patients should be kept under observation for a suitable period after the procedure.
Lactation: Not known; not recommended
Pregnancy-Lactation
Pregnancy
Postmarketing data with use in pregnant women are insufficient to determine if there is drug-associated risk of adverse developmental outcomes; drug crosses placenta and reaches fetal tissues in small amounts; in animal reproduction studies, no adverse developmental effects were observed following intravenous administration to pregnant rats and rabbits during organogenesis at doses up to 0.4 (rat) and 0.5 (rabbit) times maximum recommended human intravenous dose
Lactation
Literature reports that breast feeding after administration to mother would result in the infant receiving oral dose of approximately 0.7% of maternal intravenous dose; there is no information on effects of drug on milk production; iodinated contrast agents are excreted unchanged in human milk in very low amounts with poor absorption from gastrointestinal tract of a breastfed infant; exposure to to a breastfed infant can be minimized by temporary discontinuation of breastfeeding; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Interruption of breastfeeding after exposure to iodinated contrast agents is not necessary because potential exposure of breastfed infant to iodine is small; however, a lactating woman may consider interrupting breastfeeding and pumping and discarding breast milk for 10 hours (approximately 5 elimination half-lives) after drug administration to minimize drug exposure to breastfed infant
Interactions
Side Effects
Side effects of Iohexol :
Flushing or a sensation of heat; pain, extravasation, thrombophlebitis at the inj site; nausea, vomiting, headache, and dizziness; urticaria, pruritus, pallor, sweating, metallic taste, weakness, coughing, rhinitis, sneezing, lachrymation, visual disturbances; hypotension, tachycardia, bradycardia, transient ECG abnormalities, haemodynamic disturbances; dyspnoea, bronchospasm, angioedema, severe urticaria; convulsions, paraesthesia, paralysis; acute renal failure; thromboembolism, disseminated intravascular coagulation, thrombocytopenia; hyperthyroidism, thyroid storm thyrotoxicosis.
Potentially Fatal: Profound hypotension, pulmonary oedema, respiratory arrest, ventricular fibrillation, circulatory failure, cardiac arrest, coma.
Mode of Action
Allows for radiographic visualization through the opacification of vessels and anatomical structures in the path of flow of the contrast media.
Note
Diapac 350 350mg/ml Injection generic name is Iohexol. Diapac 350 350mg/ml Injection is manufactured by Techno Drugs Ltd.Diapac 350 is availble in all over Bangladesh.
Mes BD drug index information on Diapac 350 Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.