Ultravist after intravascular injection is very rapidly distributed in the extracellular space. Its half-life period in the distribution phase is 3 minutes.
Communication with plasma proteins at a concentration . Ultravist can not penetrate the intact blood-brain barrier, but in a small amount passes through the placental barrier (shown in rabbits).
After 1 5 min after bolus intravenous administration npp cycle detected in plasma 28 ± 6% of the introduced quantity regardless of the dose. After the introduction of the shell under the maximum brain concentration of iodine in the plasma comprising 4.5% of the dose were observed after 3.8 hours.
After the introduction of Ultravist drug in clinically acceptable doses did not reveal its metabolites.
Withdrawal Iopromide in patients with normally functioning kidneys characterized by a time equal to the half-life of around 2 hours regardless of the dose. When using Ultravist drug in doses recommended for diagnostic purposes, it takes place solely by its glomerular filtration. 30 minutes after drug administration Ultravist kidneys displayed approximately 18% of the administered dose over 3 hours – 60% and in 24 hours – 92% respectively. Total clearance by using a low (1 150 mg / ml) and high (370 1 mg / ml) doses of 110 and 103 ml / min, respectively.
After lumbar myelography Ultravist is almost entirely excreted by the kidneys within 72 hours.
- Violations of the liver and kidneys
Patients with end-stage renal failure, non-ionic contrast media can be eliminated by dialysis. Abnormal liver function does not affect the excretion of the drug Ultravist as 3 days in the feces allocated only 1.5% of the administered dose.
Indications The drug is intended for diagnostic purposes only!
Enhancing image contrast during computed tomography npp cycle, arteriography and venography, including intravenous / intra-arterial digital subtraction angiography ; intravenous urography, endoscopic retrograde cholangiopancreatography npp cycle, and arthrography research other body cavities.
– The solution for injection 240 mg iodine / ml:
Also, in the study of the subarachnoid space
– The solution for injection 370 mg iodine / ml:
It has special advantages in angiokardiografii
– Solutions for injection 300 mg I / ml and 370 mg iodine / mL are not recommended for subarachnoid space research.
Contraindications Absolute contraindications
Precautions These warnings and cautions apply to all routes of administration of the contrast agent, but noted the risk is higher when the intravascular administration.
- Hypersensitivity, especially in the presence of severe cardiovascular diseases
- Disorders of the thyroid gland
- Elderly age
- the patient’s serious condition
- kidney damage
Nephrotoxicity caused by contrast media, which is a transient impairment of renal function, may occur after administration of Ultravist drug. In rare cases, acute renal failure may develop. Risk factors include, for example:
-predshestvuyuschaya renal failure, -degidratatsiya, -saharny diabetes -mnozhestvennaya myeloma / paraproteinemia, -povtornye and / or large doses of Ultravist drug.
- Cardiovascular diseases
In patients with severe heart disease or severe coronary artery disease increased the risk of developing clinically significant hemodynamic changes and arrhythmia. In patients with valvular disease and pulmonary hypertension contrast medium administration may lead to pronounced hemodynamic disturbances. Reactions involving ischemic ECG changes and severe arrhythmias are most common in elderly patients and in patients with a history of cardiac pathology.
Intravascular administration of contrast media can cause pulmonary edema in patients with heart failure.
- npp cycle
Patients with seizures in history or other disorders the risk of seizures may be increased or neurological complications in connection with the introduction of Ultravist drug.
Patients with pheochromocytoma, there is the risk of hypertensive crisis. Premedication is recommended alpha-blockers.
- Patients with autoimmune diseases
We describe the cases of severe vasculitis or Stevens-Johnson-like syndrome in patients with a history of autoimmune disease.
The introduction of iodinated contrast agents may enhance the severity of the symptoms of myasthenia gravis.
Acute or chronic form of alcohol can increase the permeability of the blood-brain barrier. Lightweight penetration of contrast agent into the brain, can lead to reactions on the part of the central nervous system.
Introduction under the lining of the brain to be attentive to patients with seizures in history, as they have an increased risk of seizures in connection with the introduction of Ultravist drug under the lining of the brain. It should be ready for the treatment of seizures.
Introduction into other body cavities Before hysterosalpingography pregnancy should be excluded. Inflammation of the bile duct or fallopian tubes may increase the risk of reactions following ERCP or hysterosalpingography.
Use during pregnancy and lactation Relevant well-controlled studies in pregnant women have not been conducted. During pregnancy, should be avoided whenever possible radiological examinations. The benefits of any X-ray examination, with or without contrast agent should be beskrivelseanmeldelsermere carefully compared with the possible risk. At the same time the results of animal studies indicate no danger of Iopromide for diagnostic purposes in humans in regard to pregnancy, development of the embryo / fetus, childbirth and postnatal development.
Safety of Ultravist drug in infants who are breastfed, has not been studied. Ultravist excretion in breast milk is negligible, and it is unlikely to pose npp cycle a danger to infants.