ioversol (Rx)

Brand and Other Names:Optiray
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 160mg/mL (34%)
  • 240mg/mL (51%)
  • 300mg/mL (64%)
  • 320mg/mL (68%)
  • 350mg/mL (74%)
more...

Radiographic Body Imaging

Usual: 50-150 mL IV OR 100-250 mL IV of (240 mg/mL)

25-75 mL IV OR 50-150 mL IV infusion; not to exceed 150 mL

For 240 mg/mL: 35-100 mL IV OR 70-200 mL IV infusion; not to exceed 250 mL

Cerebral Arteriography

2-12 mL of 51%, 64%, 68%; may repeat as necessary; not to exceed 200 mL/procedure

20-50 mL aortic arch injection of 51%, 64%, 68% for a simultaneous 4-vessel study; not to exceed 200 mL/procedure

Aortography

45 mL (10-80 mL range) of 68%; may repeat as necessary; not to exceed 250 mL/procedure

Computed Tomography

25-75 mL IV bolus followed by 50-150 mL infusion of 74%; not to exceed 150 mL

25-75 mL IV bolus followed by 50-150 mL infusion of 68%; not to exceed 150 mL

25-75 mL IV bolus followed by 50-150 mL infusion of 64%; not to exceed 150 mL

35-100 mL IV bolus followed by 70-200 mL infusion of 51%; not to exceed 150 mL

Head Imaging

50-150 mL IV of 68% or 64% OR

100-250 mL IV of 51%

Perform scanning immediately following IV administration

Coronary Arteriography

8 mL (2-10 mL) left coronary; 6 mL (1-10 mL) right coronary; may repeat as necessary; not to exceed 250 mL/procedure

IV-DSA

160 mg/mL (34%) recommended

30-50 mL IV, repeat PRN; not to exceed 250 mL/procedure

Administration

  • Carotid arteries: 6-10 mL
  • Subclavian or brachial arteries: 2-10 mL
  • Aorta: 25-50 mL
  • Vertebral arteries: 4-8 mL
  • Major branches of the abdominal aorta

IV Urography

50-75 mL IV of 74%, 68%, or 64% OR

75-100 mL IV of 51%

Higher dosages may be indicated

  • 1.4 mL/kg IV of 350 mg/mL; not to exceed 140 mL, OR
  • 1.5-2 mL/kg IV of 320 mg/mL; not to exceed 150 mL, OR
  • 1.5 mL/kg IV of 300 mg/mL; not to exceed 150 mL, OR
  • 2 mL/kg IV of 240 mg/mL; not to exceed 200 mL

Preparatory dehydration may contribute to ARF

Dosage Forms & Strengths

injectable solution

  • 160mg/mL (34%)
  • 240mg/mL (51%)
  • 300mg/mL (64%)
  • 320mg/mL (68%)
  • 350mg/mL (74%)
more...

Angiocardiography

< 1 month

  • Safety & efficacy not established

> 1 month

  • 1.25 mL/kg (1-1.5 mL/kg) of 68% or 74% as single ventricular injection; not to exceed 5 mL/kg or 250 mL total volume

IV Urography

< 1 month

  • Safety & efficacy not established

> 1 month

  • 0.5-3 mL/kg IV (1-1.5 mL/kg usual); not to exceed 3 mL/kg

Computed Tomography

< 1 month

  • Safety & efficacy not established

> 1 month

  • Body imaging: 2 mL/kg (1-3 mL/kg) of 68%
  • Head imaging: 1-3 mL/kg of 68%
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Interactions

Interaction Checker

and ioversol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            <1%

            Cardiac disorders: Myocardial infarction, arrhythmia, atrioventricular block complete, atrioventricular block, nodal rhythm, bradycardia, angina pectoris, palpitations

            Ear and labyrinth disorders: Vertigo, tinnitus

            Eye disorders: Vision blurred, periorbital edema, conjunctivitis

            Gastrointestinal disorders: Vomiting, abdominal pain, dysphagia, dry mouth

            General disorders and administration site conditions: Chest pain, pain, hematoma, extravasation, pyrexia, swelling, asthenia, malaise, fatigue, chills, injection site pain, injection site hematoma, extravasation, pyrexia, swelling, asthenia, malaise, fatigue chills

            Infections and infestations: Rhinitis

            Injury, poisoning, and procedural complications: Heart injury, vascular pseudoaneurism

            Metabolism and nutrition disorders: Acidosis

            Musculoskeletal and connective tissue disorders: Muscular weakness, muscle spasms, back pain

            Nervous system disorders: Cerebral infarction, aphasia, tremor, dizziness, presyncope, headache, paraesthesia, dysgeusia

            Psychiatric disorders: Hallucination, visual hallucination, disorientation, anxiety

            Renal and urinary disorders: Urinary retention, renal pain, polyuria

            Respiratory, thoracic, and mediastinal disorders: Laryngeal edema, hypoxia, pulmonary edema, dyspnea, hyperventilation, cough, sneezing, nasal congestion

            Skin and subcutaneous tissue disorders: Urticaria, rash, pruritus, swelling face, hyperhidrosis, erythema

            Vascular disorders: Hypertension, hypotension, arterial spasm, vasospasm, vasodilation, flushing

            Postmarketing Reports

            Endocrine disorders: Transient hypothyroidism neonatal

            Eye disorders and administrative site conditions: Injection site reactions (nerve injury, extravasation, pruritus, induration, bruising, rash, erythema)

            Immune system disorders: Anaphylactoid shock (with multi-organ failure and cardiorespiratory arrest), anaphylactic shock, anaphylactic/hypersensitivity reaction, urticaria

            Renal and urinary disorders: Acute kidney injury

            Skin and subcutaneous tissue disorders: Erythema multiforme, acute generalized exanthematous pustulosis

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            Warnings

            Black Box Warning

            Administer procedure at facilities where staff is familiar with the recognition and treatment of allergic reactions

            When administering large doses use caution in patients with renal impairment or concurrent renal/hepatic impairment

            Neurologic events including paralysis following cerebral arteriography, arteriography of blood vessels , and spinal arteriography, reported

            Myocardial infarctions and stroke reported with angiographic procedures

            Thyroid storm reported with the use of iodinated contrast media

            Use caution in patients with multiple myeloma and pheochromocytoma

            Serious adverse events reported with inadvertent administration of iodinated contrast media intrathecally

            Contraindications

            Not for intrathecal use (may cause death, convulsions, cerebral hemorrhage, coma, paralysis, ARF)

            Cautions

            Inhibits blood coagulation

            Caution in severe renal impairment, combined renal/hepatic disease, severe thyrotoxicosis, myelomatosis, anuria, pheochromocytoma, sickle cell, CHF, chronic alcoholism, severe arterial/venous disease

            May cause renal failure in patients with advanced vascular disease, diabetes; should be well hydrated before/after procedure

            Hypersensitivity to contrast medium, iodine

            Allergies (bronchial asthma, hay fever, food allergies) reported

            Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions should be considered; reports indicate that such pretreatment does not prevent serious life-threatening reactions, but may reduce both their incidence and severity

            General anesthesia may be indicated in the performance of some procedures in selected patients; however, a higher incidence of adverse reactions has been reported in these patients

            In angiographic procedures, the possibility of dislodging plaques or damaging or perforating the vessel wall should be considered during catheter manipulations and contrast medium injection; test injections to ensure proper catheter placement are suggested

            Angiography should be avoided whenever possible in patients with homocystinuria because of risk of inducing thrombosis and embolism

            Patients with congestive heart failure should be observed for several hours following procedure to detect delayed hemodynamic disturbances which may be associated with transitory increase in circulating osmotic load

            Extreme caution during injection of contrast medium is necessary to avoid extravasation; this is especially important in patients with severe arterial or venous disease

            Selective coronary arteriography should be performed only in selected patients and those in whom expected benefits outweigh procedural risk; inherent risks of angiocardiography in patients with chronic pulmonary emphysema must be weighed against necessity for performing this procedure

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Excretion in breast milk unknown: 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

            Opacifies vessels in the path of flow of the contrast medium, permitting radiographic visualization of the internal structures until significant hemodilution occurs

            Pharmacokinetics

            Half-life: 2 hr

            Excretion: Urine (>95%)

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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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