diatrizoate meglumine/diatrizoate sodium (Rx)

Brand and Other Names:Gastrografin, Renocal 76, more...Renografin, MD-Gastroview
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection solution

  • (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL

oral/rectal solution

  • (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
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Aortography

15-40 mL IV or intra-arterially once; may repeat if necessary; not to exceed 160 mL

Contrast Enhancement of CT Brain Imaging

Tumors or non-neoplastic conditions: 1.3 mL/kg IV; not to exceed 125 mL; adequately hydrate patient prior to procedure

Excretory Urography

20 mL IV; may administer 40 mL dose if inadequate visualization occurs

Digital Subraction Angiography

20-60 mL IV; may repeat PRN; hydrate patient adequately prior to procedure

Peripheral Arteriography

Visualization of entire extremity: 20-40 mL

Visualization of lower or uper half of extremity: 10-20 mL

Radiographic Exam of GI Tract Segments

Oral: 30-90 mL

Rectal enema: Dilute 240 mL in 1000 mL tap water

Selective Renal Arteriography

5-10 mL; may repeat PRN; not to exceed 60 mL

Tomography

Dilute 25-77 mL in 1000 mL tap water; administer 240 mL of this solution PO 15-30 min prior to imaging

Dosage Forms & Strengths

injection solution

  • (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL

oral/rectal solution

  • (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
more...

Angiocardiography

Infants and children (<5 years): 10-20 mL

5-10 years: 20-30 mL; not to exceed 100 mL

Aortography

<16 years: Safety & efficacy not established

>16 years: 15-40 mL IV or intra-arterially once; may repeat if necessary; not to exceed 160 mL

Excretory Urography

<6 months: 4 mL

6-12 months: 6 mL

1-2 years: 8 mL

2-5 years: 10 mL

5-7 years: 12 mL

8-10 years: 14 mL

11-15 years: 16 mL

Radiographic Exam of GI Tract Segments

<5 years: 30 mL PO; may dilute 1:1 in a recommended liquid; alternatively may administer enema by diluting in tab water at 1:5 ration

5-10 years: 60 mL PO; may dilute 1:1 in a recommended liquid; alternatively may administer enema by diluting 90 mL in 500 mL tap water

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Adverse Effects

Frequency Not Defined

Oral/Rectal

  • Diarrhea
  • Urticaria
  • Dyspnea
  • Anaphylaxis
  • Hypoxia
  • Erythema
  • Tachyarrhythmia
  • Nausea
  • Vomiting

Injection

  • Arterial thrombosis, cardiac arrhythmia, brachial plexopathy, chest pain, choking sensation, ECG changes, edema, flushing, hypertension, hypotension, myocardial infarction, venous pain, ventricular fibrillation, chills, headache, pallor, nausea, hypothyroidism, pruritus, skin rash, urticaria, neutropenia, anaphylactoid reaction, burning sensation at injection site, muscle cramps, sneezing, wheezing, conjunctival petechiae, lacrimation
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Warnings

Black Box Warnings

Indicated for retrograde pyelography, CT, and angiography

Not for intrathecal use

Contraindications

Hypersensitivity to diatrizoate

Intrathecal use

Myelography

Cautions

Personal or family history of bronchial asthma, significant allergies, or previous reactions to contrast agents

Iodine sensitivity

Aspiration may occur following oral administration that may result in serious complications

May cause hypovolemia and hypotension due to fluid loss from hypertonic oral/rectal contrast solutions

Serious thromboembolic events including myocardial infarction and stroke reported with intravascular administration

Severe cutaneous adverse reactions (SCAR) may develop from 1 hour to several weeks after intravascular contrast agent administration; these reactions include Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms (DRESS); reaction severity may increase and time to onset may decrease with repeat administration of contrast agent; prophylactic medications may not prevent or mitigate severe cutaneous adverse reactions; avoid administering MD-76R to patients with a history of a severe cutaneous adverse reaction to MD-76R

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Pregnancy & Lactation

Pregnancy Category: B (oral); C (parenteral)

Lactation: Distributed in milk, use caution

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Contrast enhancement

Pharmacokinetics

Protein binding: Poor binding to albumin

Half-life: 100 min

Excretion: Urine; feces

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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