Peringatan Keamanan

There are no data on iopromide use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Iopromide crosses the placenta and reaches fetal tissues in small amounts. In animal reproduction studies, intravenous administration of iopromide to pregnant rats and rabbits during organogenesis at doses up to 0.35 and 0.7 times, respectively, the maximum recommended human dose based on body surface area resulted in no relevant adverse developmental effects.L46906

The safety and efficacy of iopromide have been established in pediatric patients aged 2 years and older for radiographic evaluation of cardiac chambers and related arteries, excretory urography, and contrast computed tomography of the head and body. The use of iopromide in these age groups for these indications is supported by evidence from adequate and well-controlled studies in adults and additional safety data in pediatric patients aged 2 years and older, including data from published studies.L46906

Pediatric patients who are at higher risk of experiencing an adverse reaction during and after the administration of any contrast agent include those with asthma, sensitivity to medication and/or allergens, cyanotic and acyanotic heart disease, congestive
heart failure, or serum creatinine greater than 1.5 mg/dL.L46906

Thyroid function tests indicative of thyroid dysfunction, characterized by hypothyroidism or transient thyroid suppression have been reported following iodinated contrast media administration in pediatric patients, including term and preterm neonates; Some patients were treated for hypothyroidism. After exposure to iodinated contrast media, individualize thyroid function monitoring in pediatric patients 0 to 3 years of age based on underlying risk factors, especially in term and preterm neonates.L46906

The clearance of iopromide decreases with increasing degree of renal impairment and results in delayed opacification of the urinary system. In addition, preexisting renal impairment increases the risk of acute kidney injury. Iopromide can be removed by dialysis.L46906

Long-term animal studies have not been performed with iopromide to evaluate carcinogenic potential or effects on fertility. Iopromide was not genotoxic in a series of studies including the Ames test, an in vitro human lymphocytes analysis of chromosomal aberrations, an in vivo mouse micronucleus assay, and an in vivo mouse dominant lethal assay.L46906

The manifestations of overdosage are life-threatening and affect mainly the pulmonary and cardiovascular systems. Treatment of overdosage is directed toward the support of all vital functions, and prompt institution of symptomatic therapy.L46906

The most common adverse reactions (>1%) are headache, nausea, injection site and infusion site reactions, vasodilatation, vomiting, back pain, urinary urgency, chest pain, pain, dysgeusia, and abnormal vision. Inadvertent intrathecal administration may cause death, convulsions, cerebral hemorrhage, coma, paralysis, arachnoiditis, acute renal failure, cardiac arrest, seizures, rhabdomyolysis, hyperthermia, and brain edema.L46906

Iopromide

DB09156

small molecule approved

Deskripsi

Iopromide is a low osmolar, non-ionic X-ray contrast agent for intravascular administration. It functions as a contrast agent by opacifying blood vessels in the flow path of the contrast agent, permitting radiographic visualization of the internal structures until significant hemodilution occurs.A225366 Although iopromide can cause several serious adverse effects, including cardiac events, thromboembolism, hypersensitivity reaction, and even death if administered intrathecally inadvertently, it is still deemed to have a favorable safety profile, with only 0.7% of patients in a 2 years study experiencing adverse events.A260751 Although the mechanism is unclear, women and outpatients tend to have a higher incidence of adverse events compared to other population groups.A260751

Approved by the FDA in 1995 and Health Canada in 1994 under the brand name ULTRAVIST, iopromide is used in radiological diagnosis, including, but not limited to, intra-arterial digital subtraction angiography (IA-DSA), cerebral and peripheral arteriography, peripheral venography, excretory urography, brain computer tomography (CT), coronary arteriography, left ventriculography, visceral angiography, and orthography.L46906,L46911

Struktur Molekul 2D

Berat 791.1119
Wujud solid

Peta Jejaring Molekuler
Legenda: ObatTargetGenEnzim(Panah → menunjukkan arah efek / relasi)TransporterCarrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) After intravenous administration to healthy adult subjects, the plasma iopromide concentration-time profile shows an initial distribution phase with a half-life of 0.24 hours; a main elimination phase with a half-life of 2 hours; and a terminal elimination phase with a half-life of 6.2 hours.[L46906]
Volume Distribusi The total volume of distribution at steady state is about 16 L, suggesting distribution into extracellular space.[L46906]
Klirens (Clearance) The mean total and renal clearances are 107 mL/min and 104 mL/min, respectively.[L46906]

Absorpsi

Immediately following intravascular injection, iopromide reaches peak plasma concentrations and is then rapidly distributed throughout the extracellular fluid compartment. It displays little tendency to bind to serum or plasma proteins.L46911 Iodinated contrast agents cross a disrupted blood-brain barrier.L46906

Metabolisme

Iopromide does not undergo significant metabolism, deiodination, or biotransformation.L46906

Rute Eliminasi

The amounts excreted unchanged in urine represent 97% of the dose in adult healthy subjects. Only 2% of the dose is recovered in the feces. Similar recoveries in urine and feces are observed in middle-aged and elderly patients. This finding suggests that, compared to the renal route, biliary and/or gastrointestinal excretion is not important for iopromide. During the slower terminal phase, only 3% of the dose is eliminated; 97% of the dose is disposed of during the earlier phases, the largest part of which occurs during the main elimination phase.L46906 The ratio of the renal clearance of iopromide to the creatinine clearance is 0.82, suggesting that iopromide is mainly excreted by glomerular filtration. Additional tubular reabsorption is possible.L46906

Interaksi Obat

727 Data
Aldesleukin The risk of a hypersensitivity reaction to Iopromide is increased when it is combined with Aldesleukin.
Metformin The risk or severity of lactic acidosis can be increased when Iopromide is combined with Metformin.
Cyclosporine Cyclosporine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Icosapent Icosapent may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefotiam Cefotiam may decrease the excretion rate of Iopromide which could result in a higher serum level.
Mesalazine Mesalazine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefmenoxime Cefmenoxime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefmetazole Cefmetazole may decrease the excretion rate of Iopromide which could result in a higher serum level.
Pamidronic acid Pamidronic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Tenofovir disoproxil Tenofovir disoproxil may decrease the excretion rate of Iopromide which could result in a higher serum level.
Indomethacin Indomethacin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cidofovir Cidofovir may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefpiramide Cefpiramide may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftazidime Ceftazidime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Loracarbef Loracarbef may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefalotin Cefalotin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Nabumetone Nabumetone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ketorolac Ketorolac may decrease the excretion rate of Iopromide which could result in a higher serum level.
Tenoxicam Tenoxicam may decrease the excretion rate of Iopromide which could result in a higher serum level.
Celecoxib Celecoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefotaxime Cefotaxime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Tolmetin Tolmetin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Foscarnet Foscarnet may decrease the excretion rate of Iopromide which could result in a higher serum level.
Rofecoxib Rofecoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Piroxicam Piroxicam may decrease the excretion rate of Iopromide which could result in a higher serum level.
Methotrexate Methotrexate may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cephalexin Cephalexin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Fenoprofen Fenoprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Valaciclovir Valaciclovir may decrease the excretion rate of Iopromide which could result in a higher serum level.
Valdecoxib Valdecoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Diclofenac Diclofenac may decrease the excretion rate of Iopromide which could result in a higher serum level.
Sulindac Sulindac may decrease the excretion rate of Iopromide which could result in a higher serum level.
Bacitracin Bacitracin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Amphotericin B Amphotericin B may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cephaloglycin Cephaloglycin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Flurbiprofen Flurbiprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Adefovir dipivoxil Adefovir dipivoxil may decrease the excretion rate of Iopromide which could result in a higher serum level.
Pentamidine Pentamidine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Etodolac Etodolac may decrease the excretion rate of Iopromide which could result in a higher serum level.
Mefenamic acid Mefenamic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Acyclovir Acyclovir may decrease the excretion rate of Iopromide which could result in a higher serum level.
Naproxen Naproxen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Sulfasalazine Sulfasalazine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Phenylbutazone Phenylbutazone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Meloxicam Meloxicam may decrease the excretion rate of Iopromide which could result in a higher serum level.
Carprofen Carprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefaclor Cefaclor may decrease the excretion rate of Iopromide which could result in a higher serum level.
Diflunisal Diflunisal may decrease the excretion rate of Iopromide which could result in a higher serum level.
Tacrolimus Tacrolimus may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceforanide Ceforanide may decrease the excretion rate of Iopromide which could result in a higher serum level.
Salicylic acid Salicylic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Meclofenamic acid Meclofenamic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Acetylsalicylic acid Acetylsalicylic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Carboplatin Carboplatin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Oxaprozin Oxaprozin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ketoprofen Ketoprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Balsalazide Balsalazide may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ibuprofen Ibuprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefditoren Cefditoren may decrease the excretion rate of Iopromide which could result in a higher serum level.
Atazanavir Atazanavir may decrease the excretion rate of Iopromide which could result in a higher serum level.
Colistimethate Colistimethate may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefuroxime Cefuroxime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefapirin Cefapirin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefadroxil Cefadroxil may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefprozil Cefprozil may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftriaxone Ceftriaxone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Olsalazine Olsalazine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Lumiracoxib Lumiracoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefamandole Cefamandole may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefazolin Cefazolin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefonicid Cefonicid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefoperazone Cefoperazone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefotetan Cefotetan may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefoxitin Cefoxitin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftizoxime Ceftizoxime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefradine Cefradine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Magnesium salicylate Magnesium salicylate may decrease the excretion rate of Iopromide which could result in a higher serum level.
Salsalate Salsalate may decrease the excretion rate of Iopromide which could result in a higher serum level.
Choline magnesium trisalicylate Choline magnesium trisalicylate may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefepime Cefepime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefacetrile Cefacetrile may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftibuten Ceftibuten may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cefpodoxime Cefpodoxime may decrease the excretion rate of Iopromide which could result in a higher serum level.
Antrafenine Antrafenine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Aminophenazone Aminophenazone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Antipyrine Antipyrine may decrease the excretion rate of Iopromide which could result in a higher serum level.
Tiaprofenic acid Tiaprofenic acid may decrease the excretion rate of Iopromide which could result in a higher serum level.
Lopinavir Lopinavir may decrease the excretion rate of Iopromide which could result in a higher serum level.
Etoricoxib Etoricoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Hydrolyzed Cephalothin Hydrolyzed Cephalothin may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cephalothin Group Cephalothin Group may decrease the excretion rate of Iopromide which could result in a higher serum level.
Oxyphenbutazone Oxyphenbutazone may decrease the excretion rate of Iopromide which could result in a higher serum level.
Latamoxef Latamoxef may decrease the excretion rate of Iopromide which could result in a higher serum level.
Nimesulide Nimesulide may decrease the excretion rate of Iopromide which could result in a higher serum level.
Benoxaprofen Benoxaprofen may decrease the excretion rate of Iopromide which could result in a higher serum level.
Metamizole Metamizole may decrease the excretion rate of Iopromide which could result in a higher serum level.
Zomepirac Zomepirac may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftobiprole Ceftobiprole may decrease the excretion rate of Iopromide which could result in a higher serum level.
Cimicoxib Cimicoxib may decrease the excretion rate of Iopromide which could result in a higher serum level.
Ceftaroline fosamil Ceftaroline fosamil may decrease the excretion rate of Iopromide which could result in a higher serum level.

Referensi & Sumber

Artikel (PubMed)
  • PMID: 23329965
    Gharekhanloo F, Torabian S: Comparison of allergic adverse effects and contrast enhancement between iodixanol and iopromide. Iran J Radiol. 2012 Jun;9(2):63-6. doi: 10.5812/iranjradiol.7696. Epub 2012 Jun 30.
  • PMID: 15615946
    Mortele KJ, Oliva MR, Ondategui S, Ros PR, Silverman SG: Universal use of nonionic iodinated contrast medium for CT: evaluation of safety in a large urban teaching hospital. AJR Am J Roentgenol. 2005 Jan;184(1):31-4. doi: 10.2214/ajr.184.1.01840031.

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