iodixanol (Rx)

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Brand and Other Names:Visipaque

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 270mg/mL organically bound iodine (ie, iodixanol 550mg/mL)
  • 320mg/mL organically bound iodine (ie, iodixanol 652mg/mL)
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Visipaque 320

Intra-arterial administration (arteriography)

  • Carotid arteries: 10-14 mL
  • Verterbral arteries: 10-12 mL
  • Right coronary artery: 3-8 mL
  • Left coronary artery: 3-10 mL
  • Left ventricle: 20-45 mL
  • Renal arteries: 8-18 mL
  • Aortography: 30-70 mL
  • Major aorta branch: 10-70 mL
  • Peripheral arteries: 15-30 mL
  • Aortofermoral runoffs: 20-90 mL

Intra-arterial administration (IA-DSA)

  • Carotid or vertebral arteries: 5-8 mL
  • Aortography: 10-50 mL
  • Major aorta branch: 2-10 mL
  • Aortofemoral runoffs: 6-15 mL
  • Peripheral arteries: 3-15 mL

IV administration

  • CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion not to exceed 150 mL
  • Excretory urography: 1 mL/kg, not to exceed 100 mL
  • Venography: 50-150 mL per lower extremity

Visipaque 270

Intra-arterial administration (IA-DSA)

  • Renal arteries: 10-25 mL
  • Aortography: 20-50 mL
  • Major aorta branches: 5-30 mL

IV administration

  • CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion; not to exceed 150 mL
  • Excretory urography: 1 mL/kg; not to exceed 100 mL for normal renal function
  • Venography (per lower extremity): 50-150 mL; not to exceed 250 mL

Dosage Forms & Strengths

injectable solution

  • 270mg/mL organically bound iodine (ie, iodixanol 550mg/mL)
  • 320mg/mL organically bound iodine (ie, iodixanol 652mg/mL)
more...

Intra-arterial administration

Visipaque 320

1-12 years

  • Cerebral, cardiac chambers and related major arteries, and visceral studies: 1-2 mL/kg; not to exceed 4 mL/kg

>12 years

  • Carotid arteries: 10-14 mL
  • Verterbral arteries: 10-12 mL
  • Right coronary artery: 3-8 mL
  • Left coronary artery: 3-10 mL
  • Left ventricle: 20-45 mL
  • Renal arteries: 8-18 mL
  • Aortography: 30-70 mL
  • Major aorta branch: 10-70 mL
  • Peripheral arteries: 15-30 mL
  • Aortofermoral runoffs: 20-90 mL

Intra-arterial administration (IA-DSA)

Visipaque 320

>12 years

  • Carotid or vertebral arteries: 5-8 mL
  • Aortography: 10-50 mL
  • Major aorta branch: 2-10 mL
  • Aortofemoral runoffs: 6-15 mL
  • Peripheral arteries: 3-15 mL

IV administration

Visipaque 320

>12 years

  • CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion not to exceed 150 mL
  • Excretory urography: 1 mL/kg, not to exceed 100 mL
  • Venography: 50-150 mL per lower extremity

Intra-arterial administration (IA-DSA)

Visipaque 270

1-12 years

  • CECT or excretory urography: 1-2 mL/kg; not to exceed 2 mL/kg

>12 years

  • Renal arteries: 10-25 mL
  • Aortography: 20-50 mL
  • Major aorta branches: 5-30 mL

IV administration

Visipaque 270

>12 years

  • CECT of head or body: 75-150 mL bolus, then 100-150 mL infusion; not to exceed 150 mL
  • Excretory urography: 1 mL/kg; not to exceed 100 mL for normal renal function
  • Venography (per lower extremity): 50-150 mL; not to exceed 250 mL
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Warnings

Black Box Warnings

Not for intrathecal (IT) use

Inadvertent IT administration of iodinated contrast media ha resulted in serious adverse reactions including death, convulsions, cerebral hemorrhage, coma, paralysis, arachnoiditis, acute renal failure, cardiac arrest, seizures, rhabdomyolysis, hyperthermia, and brain edema

Contraindications

Hypersensitivity to product or components

Intrathecal use

In children, prolonged fasting and use of laxative before administration is contraindicated

Product label has additional procedure-specific contraindications

Cautions

Maintain adequate hydration

Use caution in renal/hepatic impairment, cardiovascular disease, multiple myeloma, pheochromocytoma, sickle cell disease, elderly patients, and thyroid dysfunction

Increased risk of adverse effects including heart disease, renal dysfunction, asthma patients, and sensitivity to allergens or medications

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Pregnancy & Lactation

Pregnancy Category: B

Lactation: Excretion in breast millk unknown; not recmmended

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

Dimeric, isosmolar, nonionic, water-soluble, iodinated x-ray contrast agent for intravascular administration; opacifies vessels within path of flow, thereby permitting radiographic visualization of internal structures until significant dilution and elimination occurs

Pharmacokinetics

Vd: 0.26 L/kg

Excretion: 97% excreted unchanged in urine within 24 hr

Half-life: 2-4 hr (children); 2 hr (adults)

Peak plasma time: Immediate; 15-120 sec (peak enhancement); 5-15 min (optimum renal contrast); up to 1 hr (brain contrast)

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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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