Iopromide (Injection)

Iopromide injection is an iodinated contrast agent. The drug is used to locate problems in various areas of the body, including the brain, heart and blood vessels.

Overview

In the US, iopromide is known under the brand name, Ultravist. It is an injectable solution that is used in a hospital or in a clinic under the direct supervision of a medical professional.

Iopromide is one of a group of drugs called iodinated contrast agents that are used to facilitate diagnosis of conditions in the blood vessels, heart, brain, head and certain other areas of the body.

Contrast agents are drugs that are used to present clear images of the target areas in the body during some medical procedures, including angiography and CT scans.

Conditions treated

  • Diagnostic tool

Type of medicine

  • Iodinated contrast agent
  • Injectable solution

Side effects

In addition to the effects that it is intended to have, iopromide can cause a few unwanted side effects in some patients. Not everyone notices any untoward effects when they have received this medication, but if you do notice anything, you may need to seek further medical attention.

If you experience any of the following side effects, check with your GP:

  • Unusual weight loss or gain
  • Unusual weakness or tiredness
  • Trouble sleeping
  • Tingling in the feet or hands
  • Swelling of the fingers, face, lower legs, or feet
  • Sweating
  • White spots, sores, or ulcers, in the mouth or on the lips
  • Hives, skin rash, or itching
  • Sensitivity to heat
  • Red, irritated eyes
  • Red skin lesions with purple centers
  • Swelling or puffiness of the face, eyelids, around the eyes, tongue, face, or lips
  • Pale skin at the injection site
  • Pains or discomfort in the jaw, arms, back, or neck
  • Noisy breathing
  • Nervousness
  • Nausea or vomiting
  • Lower back or side pains
  • Loss of appetite
  • Joint or muscle pains
  • Irregular heartbeat
  • Irregular breathing
  • Headache
  • Frequent or increased urge to urinate
  • Reddening or flushing of the skin, especially on the neck and face
  • Fever or chills
  • Feeling of warmth or heat
  • Feeling faint, dizzy or lightheaded
  • Extreme fatigue
  • Excessive thirst
  • Dilated neck veins
  • Difficulty in swallowing or a sore throat
  • Breathing difficulties
  • Difficult, fast, noisy breathing, often with wheezing
  • Difficult or painful urination
  • Diarrhea
  • Decreased frequency or amount of urine production
  • Coughing that may produce pink frothy sputum
  • Cough
  • Convulsions
  • Chest pain
  • Chest discomfort or tightness
  • Blue lips or skin
  • Blue lips and fingernails
  • Bloody urine
  • Swelling or bloating of the arms, face, hands, feet or lower legs
  • Peeling, blistering, or loosening of the skin
  • Burning, bleeding, blistering, numbness, coldness, discoloration of the skin, hives, feeling of pressure, infection, itching, itching, lumps, pain, rash, redness, swelling, ulceration, tingling or warmth at the site of the injection

There are some effects that sometimes happen that will not necessitate more attention from your doctor. These effects usually disappear as your body gets used to the drug. Your nurse or doctor may offer advice on how to prevent or manage these effects.

If you are affected by any of the following side effects, mention them to your nurse or treating physician if they prove to be persistent or especially bothersome or if you have any concerns or questions:

  • Voice changes
  • Tender, swollen glands in the neck
  • Sleepiness or unusual drowsiness
  • Sensation of spinning
  • Reddening, pain, or swelling of the eyes, eyelids, or of the inner lining of the eyelids
  • Muscle tension or tightness
  • Loss of taste
  • Loss of strength or energy
  • Lack of coordination
  • Increased sensitivity of the eyes to sunlight
  • Hearing loss
  • Severe and throbbing headaches
  • General feeling of discomfort or being unwell
  • Feeling of continual movement of self or surroundings
  • Excessive muscle tone
  • Dry mouth
  • Discharge or excessive tearing from the eyes
  • Difficulty moving
  • Tinnitus in the ears
  • Visual changes
  • Changes in taste
  • Burning, itching or dry eyes
  • Crawling, burning, itching, prickling, numbness, tingling, or "pins and needles" sensations
  • Body aches or pain
  • Bigger than usual, dilated, or enlarged pupils
  • Belching or more frequent passing of gas
  • Agitation
  • Acid or sour stomach
  • Stomach or abdominal pains or discomfort

The list of effects in this guide is not necessarily exhaustive. If you notice any other odd effects, you should speak to your nurse or doctor about them.

Dosage

You will be given iopromide while you are in a hospital or clinic as part of your diagnostic treatment. A medical professional will always give you this medicine.

The solution is administered through a needle that will be placed into one of your veins or arteries. While you are being given this medication, try to drink lots of extra fluid. This will encourage greater urine production, which will help to prevent kidney problems.

Interactions

Drug interactions

Some medicines should not be used with other drugs, as there may be an interaction between them. In some case, using two drugs at the same time may be appropriate for the patient's treatment. In this case, the treating physician will probably change the dose or frequency of one or both of the drugs or may recommend other precautions that will prevent any interaction or manage its effects. While you are using iopromide, you must tell your treating physician if you are using any other medication, especially those in the list that follows below. Patients should note that this list is not necessarily all-inclusive and the drugs in it are noted on the basis of their significance:

It is not recommended to use iopromide with Metformin. Your doctor may elect to change some of your other drugs or may decide not to give you iopromide.

In addition, you should note that using iopromide with any of the following medicines could cause an increased likelihood of side effects, but it may be the most appropriate course of treatment in your case. If you are told to take both drugs at the same time, your treating physician may change the frequency or dose of one or both products:

  • Tyropanoate Sodium
  • Ipodate
  • Iopanoic Acid
  • Iocetamic Acid

Other interactions

There are some drugs that should not be used when you are eating or eating specific types of food, as this could cause an interaction. In addition, using tobacco or alcohol with some drugs can cause an interaction. Be sure to talk to your treating physician about the use of iopromide with alcohol, tobacco and food.

Medical interactions

Some historical or existing medical problems can affect how iopromide works. Be sure to have a full and frank discussion about your medical history with your treating physician before you begin using this medication.

Iopromide should be used with extreme caution in the patients with the following conditions as it may increase the likelihood of allergic reactions:

  • Asthma
  • Allergy to iodine
  • Allergy to food
  • Allergy to a contrast agent
  • Allergic rhinitis (hay fever)

Iopromide should be used with caution in patients who have any of the following conditions, as it may make these illnesses worse:

  • Sickle cell anemia (inherited blood disorder)
  • Pheochromocytoma (adrenal problem)
  • Hyperthyroidism (overactive thyroid)
  • Heart or blood vessel disease
  • Blood clotting problems (e.g., phlebitis, thrombosis)

Iopromide should be used with caution in patients who have any of the following conditions, as it may present an increased risk of kidney failure:

  • Paraproteinemia (high amount of paraprotein in the blood)
  • Multiple myeloma (cancer of plasma cells)
  • Kidney disease
  • Diabetes
  • Dehydration
  • Congestive heart failure
  • Blood vessel disease, severe

Iopromide should not be given to pediatric patients who are suffering from dehydration as a result of the use of laxatives or prolonged fasting.

Patients who have the genetic condition, homocystinuria should not undergo angiography as this procedure presents an increased risk of blood clotting issues.

Iopromide should be used with extreme caution in patients with kidney disease, because the effect of the medication may be increased due to the slower excretion of the drug from the body.

Warnings

Before you decide to use iopromide, you should discuss the pros and cons of doing so with your health care professional and make your decision based on this discussion. In the case of iopromide, the following potential issues should be taken into consideration:

You must tell your treating physician if you have ever noticed any unusual or allergic response to this drug or any other medication. You should also tell your treating physician if you are allergic to food colors, preservatives, animal by-products or food groups.

Although there is nothing to say that iopromide should not be used in children, safety and efficacy have not been proven in pediatric patients who are aged under two years.

There have been no definitive studies into the effect of iopromide in geriatric patients. However, old people are more prone to kidney problems, which may mean that the dose rate in these patients should be adjusted to compensate for this if appropriate.

Studies have not demonstrated that this medicine could present a danger to the unborn baby in any trimesters. However, pregnant women should discuss this with their healthcare professional prior to starting treatment with this drug.

There is nothing to show that iopromide could be ingested by a nursing infant. However, if you are breastfeeding, you may prefer to err on the side of caution and find an alternative feeding solution for your child until you have finished being treated with this drug. Discuss the risks of breastfeeding while using iopromide with your midwife or healthcare professional if you have concerns in this regard.

You must attend your health care professional for regular check-ups while you are being treated with this medicine. These visits are important as they allow your doctor to make sure that the drug has not caused any side effects in case you are required to undergo tests that would require its use again.

Some patients may experience a serious allergic response to iopromide. Anaphylaxis can be a potentially fatal condition that always necessitates urgent medical attention. You must alert your nurse or treating physician immediately if you notice any of the following effects:

  • Skin rash
  • Itchy skin
  • Shortness of breath
  • Swelling of the tongue, throat, or face
  • Sweating
  • Tightness in the chest

You must tell your treating physician if you or your child have ever experienced an allergic reaction to any medication or dye that has been used for a procedure or test.

Iopromide can cause kidney problems in some patients. This is more likely if you are given too large a dose of this drug. Tell your healthcare professional right away if you notice any of the following symptoms after you have received this drug:

  • Confusion
  • Agitation
  • Reduced urine production
  • Dizziness
  • Headaches
  • Twitching muscles
  • Unexplained, rapid weight gain
  • Swelling of ankles, face, or hands

You must tell your treating physician immediately if you notice any of the following sensations around the site of your injection of iopromide:

  • Mild burning
  • Pain
  • Feeling of cold or warmth
  • Peeling skin
  • Redness
  • Swelling or bloating of the arms, face, hands, feet, or lower legs

During your treatment with this drug, you will be exposed to radiation. If you have any concerns in this regard, you should check with your treating physician.

Be sure to tell your healthcare professional or dentist that you are using iopromide, as this drug can affect some test results.

You should not use any other drugs while you are being treated with iopromide unless you have cleared their use with your healthcare professional first. This should include over the counter products, vitamin supplements, and herbal remedies.

Storage

Iopromide is only used in a hospital or clinic setting where it will be correctly stored, as per the manufacturer's guidelines.

Summary

Iopromide is an injectable solution that is used in hospitals and clinics to aid the diagnosis of certain medical conditions.

This medicine can cause a few side effects and also interacts with a number of medications and medical conditions. For this reason, you must discuss your medical history fully with your treating physician before undergoing treatment with this medicine. You will also need to attend your GP for regular check-ups to make sure that the drug has not caused any unwanted side effects.

Patients should note that iopromide cannot cure your illness. It is purely used as a diagnostic tool.