diatrizoate meglumine and diatrizoate sodium

Action and Spectrum

Actions and spectrum: 

• Contrast Enhancement: diatrizoate meglumine and diatrizoate sodium are radiopaque agents that contain iodine. When administered intravenously or orally, they enhance the visibility of blood vessels, organs, and other structures during imaging procedures. They help to improve the quality and diagnostic accuracy of the images by providing contrast between different tissues. 
• X-ray Absorption: diatrizoate meglumine and diatrizoate sodium have a high atomic number due to the presence of iodine. This high atomic number allows them to absorb X-rays effectively. As X-rays pass through the body, the contrast agents absorb the X-rays and create a contrast between the structures being imaged and the surrounding tissues. 
• Vascular Imaging: diatrizoate meglumine and diatrizoate sodium are particularly useful in visualizing blood vessels. They are commonly used in angiography, a procedure that involves injecting the contrast agent directly into the blood vessels to visualize their size, shape, and any abnormalities. 
• Organ Imaging: These contrast agents can also be used to enhance the visualization of various organs, such as the urinary tract, gastrointestinal tract, and gallbladder. They help to identify abnormalities, blockages, or lesions in these organs, aiding in the diagnosis of conditions such as urinary tract disorders, gastrointestinal diseases, or gallbladder issues. 

The spectrum of diatrizoate meglumine and diatrizoate sodium refers to the range of anatomical structures and systems that can be imaged effectively using these contrast agents. Their high radiopacity and ability to provide contrast make them suitable for imaging blood vessels, organs, and other structures throughout the body. However, the specific use and imaging capabilities may vary depending on the imaging modality, concentration, and administration route chosen by the healthcare professional. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Oral/Rectal 

• Urticaria 
• Anaphylaxis 
• Erythema 
• Nausea 
• Diarrhea 
• Dyspnea 
• Hypoxia 
• Tachyarrhythmia 
• Vomiting 

Injection 

cardiac arrhythmia, chest pain, ECG changes, flushing, hypotension, venous pain, headache, nausea, pruritus, urticaria, anaphylactoid reaction, muscle cramps, wheezing, lacrimation, Arterial thrombosis, brachial plexopathy, choking sensation, edema, hypertension, myocardial infarction, ventricular fibrillation, pallor, hypothyroidism, skin rash, neutropenia, injection site burning sensation, sneezing, conjunctival petechiae 

Black Box Warning

Black Box Warning: 

diatrizoate meglumine and diatrizoate sodium do not have a specific black box warning 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: Patients who have a known hypersensitivity or allergy to diatrizoate meglumine, diatrizoate sodium, or any other components of the contrast agent should not receive these medications. Hypersensitivity reactions can range from mild skin reactions to severe anaphylaxis, which can be life-threatening. 
• Severe Renal Impairment: Patients with an eGFR less than 30 mL/min/1.73m², are at an increased risk of contrast-induced nephropathy. The use of diatrizoate meglumine and diatrizoate sodium should be avoided in these individuals to prevent further deterioration of renal function. 
• Thyroid Disorders: Patients with uncontrolled hyperthyroidism or thyrotoxicosis may be at an increased risk of adverse effects related to iodine exposure. diatrizoate meglumine and diatrizoate sodium should be used with caution or avoided in patients with these conditions. 
• Pheochromocytoma: Due to the potential risk of inducing hypertensive crisis, the use of diatrizoate meglumine and diatrizoate sodium is contraindicated in patients with known or suspected pheochromocytoma, a rare adrenal gland tumor that can cause high blood pressure. 
• Pregnancy and Lactation: diatrizoate meglumine and diatrizoate sodium may cross the placenta and enter breast milk. While they are considered safe for use in diagnostic imaging during pregnancy and lactation.

Caution: 

• Allergic Reactions: Although uncommon, allergic reactions to diatrizoate meglumine and diatrizoate sodium can occur. Patients with a history of allergic reactions to iodinated contrast agents or other allergens should be closely monitored during and after the procedure. 
• Asthma or Allergies: Patients with a history of asthma or other allergic conditions may have an increased risk of developing hypersensitivity reactions to contrast agents. Special caution should be exercised, and appropriate management strategies should be in place. 
• Diabetes: diatrizoate meglumine and diatrizoate sodium contain iodine, which can interfere with thyroid function and glucose metabolism. Patients with diabetes should be closely monitored during and after the procedure, as changes in blood glucose levels may occur. 
• Thyroid Disorders: Patients with known thyroid disorders, such as hyperthyroidism or hypothyroidism, should be carefully evaluated before the administration of contrast agents. The iodine content in diatrizoate meglumine and diatrizoate sodium may affect thyroid function. 
• Medication Interactions: Diatrizoate meglumine and diatrizoate sodium may interact with certain medications, including those that affect renal function or interfere with iodine metabolism. Healthcare professionals should review the patient’s medication profile to identify any potential interactions.

Comorbidities: 

• Renal Impairment: Patients with pre-existing renal impairment are at an increased risk of developing contrast-induced nephropathy. Close monitoring of renal function, hydration status, and consideration of alternative imaging modalities may be necessary in these individuals. 
• Allergic Reactions: Patients with a history of allergic reactions to iodinated contrast agents or other allergens may be at an increased risk of developing hypersensitivity reactions to diatrizoate meglumine and diatrizoate sodium. Special caution should be exercised, and appropriate management strategies should be in place. 
• Asthma or Allergies: Patients with a history of asthma or other allergic conditions may have an increased risk of developing hypersensitivity reactions to contrast agents. Close monitoring and appropriate management strategies should be implemented. 
• Cardiovascular Disease: Patients with significant cardiovascular disease, such as congestive heart failure or unstable angina, may be at an increased risk of cardiovascular complications during or after the administration of contrast agents. Close monitoring of vital signs and cardiovascular status is necessary in these individuals. 
• Thyroid Disorders: Patients with known thyroid disorders, such as hyperthyroidism or hypothyroidism, may be at risk of developing thyroid-related complications due to the iodine content in diatrizoate meglumine and diatrizoate sodium. 

Pregnancy / Lactation

Pregnancy consideration: US FDA pregnancy category: B (oral); C (parenteral) 

Lactation: Excreted into human milk: Yes  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

diatrizoate meglumine and diatrizoate sodium are iodinated contrast agents used in medical imaging procedures to enhance the visibility of certain body structures during diagnostic examinations. Here is a brief overview of their pharmacology: 

Mechanism of Action: diatrizoate meglumine and diatrizoate sodium are radiopaque compounds that contain iodine. When injected or administered orally, they selectively absorb X-rays and attenuate the X-ray beam. This leads to increased radiodensity in the region where they accumulate, resulting in improved visualization of blood vessels, organs, or other structures during imaging.  

Pharmacodynamics: 

• Radiopacity: diatrizoate meglumine and diatrizoate sodium are iodinated contrast agents that have high X-ray attenuation properties. When administered, they selectively absorb X-rays and attenuate the X-ray beam. This increased radiodensity results in improved visualization of blood vessels, organs, or other structures during imaging, aiding in the accurate diagnosis and evaluation of medical conditions. 
• Contrast Enhancement: By increasing the contrast between the targeted tissues or vessels and their surrounding structures, diatrizoate meglumine and diatrizoate sodium enhance the visibility of specific regions of interest. This allows for better differentiation and delineation of anatomical structures, facilitating the identification of abnormalities or pathology. 
• Vascular Opacification: When injected intravenously, these contrast agents rapidly distribute into the vascular system. They selectively accumulate in the blood vessels, enhancing their visibility and aiding in the assessment of blood flow, vascular abnormalities, or other vascular-related conditions. 
• Tissue Enhancement: diatrizoate meglumine and diatrizoate sodium may also provide enhancement of non-vascular tissues, such as organs or soft tissues, during imaging. This can assist in the evaluation of organ function, structural abnormalities, or the presence of tumors or lesions.

Pharmacokinetics: 

Absorption 

diatrizoate meglumine and diatrizoate sodium are typically administered via intravenous injection or oral ingestion for imaging purposes. When given orally, they are poorly absorbed from the gastrointestinal tract, and their absorption is limited. However, when injected intravenously, they are rapidly and effectively distributed throughout the body. 

Distribution 

Following intravenous administration, diatrizoate meglumine and diatrizoate sodium rapidly distribute into the extracellular fluid and selectively accumulate in the targeted tissues or blood vessels for imaging. They have relatively large volumes of distribution, indicating extensive distribution into body tissues. 

Metabolism 

diatrizoate meglumine and diatrizoate sodium undergo minimal metabolism in the body. They are primarily eliminated unchanged through renal excretion. However, some minor metabolic transformations, such as glucuronidation or deiodination, may occur to a limited extent. 

Elimination and excretion 

The elimination of diatrizoate meglumine and diatrizoate sodium occurs primarily through renal excretion. A small fraction of the administered dose may also undergo biliary excretion and be excreted in the feces. 

Adminstartion

Administration: 

• Intravenous Injection: diatrizoate meglumine and diatrizoate sodium are commonly administered intravenously. The contrast agent is injected directly into a vein, usually in the arm or hand, using a sterile technique. The injection is performed by a healthcare professional who is trained in administering intravenous medications. 
• Oral Ingestion: In some cases, diatrizoate meglumine can be given orally for certain diagnostic imaging procedures. The patient is instructed to drink a specific quantity of the contrast agent in the form of a solution or suspension. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: diatrizoate meglumine and diatrizoate sodium 

Pronounced: (Die-uh-TRY-zoh-ate MEG-loo-meen and die-uh-TRY-zoh-ate SO-dee-um)  

Why do we use diatrizoate meglumine and diatrizoate sodium? 

• Radiographic Imaging: diatrizoate meglumine and diatrizoate sodium are often used in radiographic procedures, such as X-rays, to enhance the visibility of specific body structures. They help in highlighting blood vessels, organs, and tissues, allowing for better visualization and detection of abnormalities or diseases. 
• Computed Tomography (CT) Scans: These contrast agents are frequently utilized in CT scans to improve the visualization of blood vessels, organs, and soft tissues. They enhance the contrast between different tissues, making it easier for radiologists to interpret the images and detect any abnormalities. 
• Angiography: diatrizoate meglumine and diatrizoate sodium are commonly used in angiography, which involves imaging of blood vessels. They help in visualizing the blood vessels and evaluating their structure, function, and any abnormalities, such as blockages or aneurysms. 
• Myelography: These contrast agents may be used in myelography, a procedure that involves imaging the spinal cord and surrounding structures. They are injected into the spinal canal to enhance the visibility of the spinal cord and nerve roots during imaging.