diatrizoate meglumine/diatrizoate sodium (Gastrografin, Renocal 76, Renografin, MD-Gastroview)
Classes: Iodinated Contrast Media
Dosing and uses of Gastrografin, Renocal 76 (diatrizoate meglumine/diatrizoate sodium)
Adult dosage forms and strengths
injection solution
- (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
oral/rectal solution
- (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
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
Pediatric dosage forms and strengths
injection solution
- (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
oral/rectal solution
- (660mg diatrizoate meglumine/100mg diatrizoate sodium)/1mL
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
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
Pregnancy and 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.
Pharmacology of Gastrografin, Renocal 76 (diatrizoate meglumine/diatrizoate sodium)
Mechanism of action
Contrast enhancement
Pharmacokinetics
Protein binding: Poor binding to albumin
Half-life: 100 min
Excretion: Urine; feces
