Dosing and uses of Visipaque (iodixanol)
Adult dosage forms and strengths
injectable solution
- 270mg/mL organically bound iodine (ie, iodixanol 550mg/mL)
- 320mg/mL organically bound iodine (ie, iodixanol 652mg/mL)
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
Pediatric dosage forms and strengths
injectable solution
- 270mg/mL organically bound iodine (ie, iodixanol 550mg/mL)
- 320mg/mL organically bound iodine (ie, iodixanol 652mg/mL)
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
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
Pregnancy and 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.
Pharmacology of Visipaque (iodixanol)
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)
