Iopromide (injection route)


    Brand Name

    US Brand Name

    Ultravist


    Description

    Iopromide injection is used to help diagnose or find problems in the brain, breast, heart, head, blood vessels, stomach, and other parts of the body. It is an iodinated contrast agent. Contrast agents are used to create a clear picture of the different parts of the body during certain medical procedures such as CT scans and angiography.

    This medicine is to be used only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of iopromide injection in children. However, safety and efficacy have not been established in children 2 years of age and younger.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of iopromide injection in the elderly. However, elderly patients are more likely to have kidney problems, which may require caution and an adjustment in the dose for patients receiving iopromide injection.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Levothyroxine
    • Liothyronine
    • Metformin

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Iocetamic Acid
    • Iopanoic Acid
    • Ipodate
    • Tyropanoate Sodium

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Allergy to a contrast agent, history of or
    • Asthma—Use with caution. May increase risk of having allergic reactions.
    • Blood clotting problems (eg, phlebitis, thrombosis) or
    • Heart or blood vessel disease or
    • Hyperthyroidism (overactive thyroid) or
    • Pheochromocytoma (adrenal problem) or
    • Sickle cell disease (inherited blood disorder)—Use with caution. May make these conditions worse.
    • Congestive heart failure or
    • Dehydration or
    • Diabetes or
    • Kidney disease or
    • Multiple myeloma (cancer of plasma cells) or
    • Paraproteinemia (high amount of paraprotein in the blood)—May increase risk of having kidney failure.
    • Dehydration (caused by prolonged fasting or use of laxatives)—Should not be given in pediatric patients with this condition.
    • Homocystinuria (genetic disease)—Patients with this condition should avoid undergoing angiography because of the increase risk of having blood clotting problems.
    • Kidney problems—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A doctor or other trained health professional will give you or your child this medicine in a hospital. This medicine is given through a needle placed in an artery or a vein.

    Drink extra fluids so you will pass more urine while you or your child are receiving this medicine. This may help prevent kidney problems.


    Precautions

    It is very important that your doctor check your or your child's progress closely while you are receiving this medicine to see if the medicine is working properly and to decide if you should continue to receive it. Blood and urine tests may be needed to check for any unwanted effects.

    This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have chest tightness, cough, difficulty swallowing, dizziness, fast heartbeat, hives, itching, skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, trouble breathing, or unusual tiredness or weakness after you receive this medicine.

    Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis can occur with this medicine. Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

    Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

    This medicine may cause heart attack, stroke, and blood clotting problems. Tell your doctor right away if you or your child has chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, nausea, unusual sweating, faintness, coughing up blood, numbness or weakness in your arm or leg, or on one side of your body, sudden or severe headache, or problems with vision, speech, or walking after receiving this medicine.

    This medicine may cause hypothyroidism (underactive thyroid) in children 3 years of age and younger. Children with congenital (from birth) heart problems may have an increased risk of hypothyroidism. Check with your doctor right away if your child has depressed mood, dry skin and hair, feeling cold, hair loss, hoarseness or a husky voice, muscle cramps and stiffness, slowed heartbeat, weight gain, or unusual tiredness or weakness.

    Tell your doctor right away if you or your child have mild, burning pain, feeling of warmth or coldness, peeling of the skin, redness, or swelling at the injection site.

    While using this medicine, you may be exposed to radiation. Talk with your doctor if you have concerns about this.

    Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    Less common

    • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
    • chest pain
    • feeling faint, dizzy, or lightheadedness
    • feeling of warmth or heat
    • flushing or redness of the skin, especially on the face and neck
    • frequent strong or increased urge to urinate
    • headache
    • sweating

    Rare

    • Bloating or swelling of the face, arms, hands, lower legs, or feet
    • bluish lips or skin
    • chest discomfort or tightness
    • cough
    • decreased frequency or amount of urination
    • difficult or painful urination
    • excessive thirst
    • fever or chills
    • irregular heartbeat
    • nausea or vomiting
    • pain or discomfort in the arms, jaw, back, or neck
    • pale skin at injection site
    • seizures
    • tingling of the hands or feet
    • trouble breathing
    • unusual tiredness or weakness
    • unusual weight gain or loss

    Incidence not known

    • Black, tarry stools
    • blistering, peeling, or loosening of the skin
    • bloody urine
    • blue lips and fingernails
    • coughing that sometimes produces a pink frothy sputum
    • diarrhea
    • difficulty with swallowing or sore throat
    • dilated neck veins
    • joint or muscle pain
    • loss of appetite
    • lower back or side pain
    • nervousness
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • red, irritated eyes
    • red skin lesions, often with a purple center
    • sensitivity to heat
    • skin rash, hives, or itching
    • sores, ulcers, or white spots in the mouth or on the lips
    • swelling of the face, fingers, feet, or lower legs
    • swollen glands
    • trouble sleeping
    • unusual bleeding or bruising

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Change in taste
    • changes in vision
    • loss of taste

    Rare

    • Acid or sour stomach
    • agitation
    • belching or passing of gas
    • body aches or pain
    • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
    • difficulty with moving
    • dry mouth
    • excessive muscle tone
    • general feeling of discomfort or illness
    • lack of coordination
    • loss of strength or energy
    • muscle tension or tightness
    • sleepiness or unusual drowsiness
    • stomach discomfort or pain
    • tender, swollen glands in the neck
    • voice changes

    Incidence not known

    • Bigger, dilated, or enlarged pupils (black part of the eye)
    • burning, dry, or itching eyes
    • continuing ringing or buzzing or other unexplained noise in the ears
    • discharge, excessive tearing
    • feeling of constant movement of self or surroundings
    • headache, severe and throbbing
    • hearing loss
    • increased sensitivity of the eyes to light
    • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
    • sensation of spinning

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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