Iohexol Injection

Pharmacology: This product is a commonly used contrast agent for X-ray and CT examinations, and can be used in blood vessels, spinal canals, and body cavities. Animal test results show that this product has an enhancement effect on dog liver, abdominal aorta, and CT scan images. Toxicology: Proteinuria occurs during dog renal artery angiography.

The main ingredients and chemical names of this product are: N, N'-bis (2,3-dihydroxypropyl) -5- [N- (2,3-dihydroxypropyl) acetamido] -2,4,6-triiodo-1,3-benzenedicarbamide. Molecular formula: C19H26I3N3O9 Molecular weight: 821.14

This product is a colorless to light yellow clear liquid.

1. Intravascular application: This product is used clinically for urography and cardiovascular angiography in adults and children, as well as cerebral angiography, peripheral and various arterial angiography, venography, digital subtraction and CT enhanced scanning in adults. 2. Subarachnoid application: It is suitable for myelography in adults and children, and for CT scanning of the brain pool after subarachnoid injection. 3. Intracavitary application: It is suitable for various body cavity examinations, including oral. Such as arthrography; endoscopic retrograde pancreatocholangiopancreatography (ERCP); hernia sac angiography; urography; hysterosalpingography; sialography and various gastrointestinal examinations using oral water-soluble contrast agents.

1 Reference table of intravascular dosage Application items Concentration Dosage Notes Urethral angiography Adults Children >7kg <7kg 300mgI/ml or 350mgI/ml 240mgI/ml or 300mgI/ml 240mgI/ml or 300mgI/ml 40～80ml 40～80ml 4ml/kg 3ml/kg 3ml/kg 2ml/kg (maximum 40ml) Higher concentrations of contrast agents can be used for large doses of urinary tract angiography Arteriography Aorta and vascular angiography Selective cerebral arteriography Aortography Limb arteriography Other arteriography Venography (limbs) 300mgI/ml 300mgI/ml 350mgI/ml 300mgI/ml or 350mgI/ml 300mgI/ml 240mgI/ml 30～40ml for each injection 5-10ml per injection 40-60ml per injection Depends on the examination items 20-100ml (limbs) Cardiovascular angiography Adults Left ventricle aortic root injection Selective coronary angiography Children or 300mgI/ml 350mgI/ml350mgI/ml300mgI/ml or 350mgI/ml 30-60ml per injection 4-8ml per injection Depends on age, weight and disease (maximum 8ml/kg) Digital subtraction intra-arterial injection Intravenous injection 140mgI/ml or 240mgI/ml or 300mgI/ml300mgI/ml or 350mgI/ml 1-15ml per injection 1-15ml per injection 1-15ml per injection 20-60ml per injection 20-60ml per injection Depends on the angiography site. CT enhanced scan 140mgI/ml or 240mgI/ml or 300mgI/ml or 350mgI/ml 100～400ml 100～250ml 100～200ml 100～150ml The total iodine content is usually 30～60g; low-concentration contrast agents are suitable for intravenous drip, high-concentration contrast agents are suitable for rapid intravenous injection, and the dosage for children is reduced as appropriate. 2 The dosage and concentration of subarachnoid application depend on the type of examination, the technology used, and the size of the subarachnoid space. The general injection method is lumbar puncture, puncture between the 3rd and 4th lumbar segments (lumbar and thoracic myelography), or lateral cervical puncture between the 1st and 2nd cervical segments (cervical myelography). If lumbar puncture is used for cervical myelography, be very careful when tipping the patient to prevent a large amount of high-concentration contrast agent from entering the brain. To reduce the mixing of contrast agent and cerebrospinal fluid, an injection speed of 1 to 2 minutes can be used. The amount of contrast agent is shown in the table below. Reference table of contrast agent dosage Application items Concentration Dosage Lumbar and thoracic myelography (lumbar puncture) Cervical myelography (lumbar puncture) Cervical myelography (lateral cervical puncture) CT ventriculography (lumbar puncture) 180mgI/ml or 240mgI/ml 240mgI/ml or 300mgI/ml 240mgI/ml or 300mgI/ml 180mgI/ml or 240mgI/ml 10～15ml 8～12ml 10～12ml 7～10ml 6～10ml 6～8ml 5～15ml 4～12ml Pediatric myelography <2 years old 2～6 years old >6 years old 180mgI/ml 180mgI/ml 180mgI/ml 2～6ml 4～8ml 6～12ml The total iodine content should not exceed 3g to reduce the possibility of adverse reactions. 3 Reference table of contrast agent dosage for intracavitary application Application item Concentration Dosage Arthrography 240mgI/ml or 300mgI/ml or 350mgI/ml5-20ml5-15ml5-10ml Endoscopic pancreatic duct/bile duct and combined pancreatic duct radiography 240mgI/ml20-50ml Hernia sac radiography 240mgI/ml50ml Hysterosalpingography 240mgI/ml or 300mgI/ml15-50ml15-25ml Sialography 240mgI/ml or 300mgI/ml0.5-2ml0.5-2ml Gastrointestinal examination - (oral) 180mgI/ml or 350mgI/ml10-200ml10-200ml.

1A small number of patients may experience some mild reactions, such as: short-term warmth, slight pain, flushing, nausea/vomiting, mild chest pain, skin itching and urticaria. 2Headache, nausea and vomiting are the most common adverse reactions to myelography. Severe headaches lasting for several days may occur intermittently. Other mild adverse reactions found so far include short-term dizziness, back pain, neck pain or limb pain, and various sensory abnormalities. There have also been cases where EEG recordings showed unclear transient changes (slow waves). Aseptic meningitis has been found after myelography with water-soluble contrast agents. Similar situations have been reported when this product was used for myelography, but they were very mild and short-lived. 3There are also reports of delayed adverse reactions in some patients within hours to days after the contrast.

1. Patients with obvious thyroid disease. 2. Patients with a history of severe reaction to iohexol injection. 3. Patients with a history of epilepsy should not use iohexol in the subarachnoid space. 4. Lumbar puncture is contraindicated for patients with severe local infection or systemic infection who may develop bacteremia. 5. Since radiation exposure should be avoided as much as possible during pregnancy, the pros and cons of X-ray examinations need to be weighed. Unless the doctor deems it necessary, pregnant women should not use it. 6. Due to dose limitations, it is not advisable to repeat angiography immediately for those who fail to perform angiography.

Precautions for children: Precautions for pregnancy and lactation: Please refer to contraindications and precautions. Precautions for the elderly:

1. The use of contrast media may cause transient renal insufficiency, which may cause lactic acidosis in diabetic patients taking hypoglycemic drugs (metformin). As a precaution, biguanide hypoglycemic drugs should be discontinued 48 hours before the use of contrast media, and the medication should be resumed only after renal function has stabilized. 2. Patients treated with interleukin-2 within two weeks are at increased risk of delayed reactions (cold-like symptoms and skin reactions). 3. All iodine-containing contrast media may interfere with thyroid function tests. The iodine binding capacity of thyroid tissue may be reduced by contrast media and may take several days or even two weeks to fully recover. 4. High concentrations of contrast media in serum and urine may affect laboratory measurements of bilirubin, protein, or inorganic substances (such as iron, copper, calcium, and phosphorus). These tests should not be performed on the day of contrast media use.

Keep away from light and store in a sealed container.

100 ml: 30 g (Ⅰ)