ethiodized oil

Action and Spectrum

Actions and spectrum: 

ethiodized oil, also known as ethyl esters of iodized fatty acids, is a contrast agent used in medical imaging procedures. It is primarily used as an injectable radiopaque agent for lymphography and cholangiography. ethiodized oil is selectively taken up by the lymphatic system or biliary system, allowing visualization and evaluation of the lymph nodes or biliary ducts during diagnostic procedures. 

The spectrum of ethiodized oil refers to its ability to provide contrast and enhance imaging of the lymphatic system or biliary system. It helps to delineate the lymph nodes or biliary structures, allowing for better visualization and evaluation of abnormalities or diseases in these areas. 

Drug Interaction

Adverse Reaction

Post marketing Reports 

Eye disorders: vein thrombosis 

administration site and General disorders: pain, Fever, granuloma 

Immune system disorders: anaphylactic reaction, Hypersensitivity, anaphylactoid reaction 

Respiratory, mediastinal and thoracic disorders: dyspnea, acute respiratory distress, Pulmonary embolism, cough 

Endocrine disorders:  hyperthyroidism, Hypothyroidism, thyroiditis 

Gastrointestinal disorders: vomiting, Nausea, diarrhea 

Hepatobiliary disorders: vein thrombosis 

CNS disorders: Cerebral embolism 

Urinary disorders: Renal insufficiency 

Lymphography 

• Lymphangitis 
• Edema 
• Fever 
• Allergic dermatitis 
• Cardiovascular collapse 
• Thrombophlebitis 
• Dyspnea and cough 
• Iodism 

Hysterosalpingography 

• Foreign body reactions 
• Abdominal pain 
• pelvic inflammatory disease exacerbation  

intra-arterial Hepatic injection 

Other reactions: abnormalities of liver enzymes, liver decompensation, Hepatic ischemia, and renal insufficiency
Common reactions: abdominal pain, Fever, vomiting and nausea  

Procedural risks: Vascular infections and complications 

Black Box Warning

Black Box Warning: 

There is no specific black box warning associated with the use of ethiodized oil. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: ethiodized oil should not be used in individuals who have a known hypersensitivity or allergy to ethiodized oil or any of its components. 
• Thyrotoxicosis: ethiodized oil should not be used in individuals with thyrotoxicosis or hyperthyroidism as it can exacerbate thyroid hormone release and worsen the condition. 
• Severe liver disease: ethiodized oil should be used with caution in individuals with severe liver disease as it can potentially worsen liver function. 
• Pre-existing bleeding disorders: ethiodized oil should be used with caution in individuals with pre-existing bleeding disorders or those taking anticoagulant medications, as it can increase the risk of bleeding.

Caution: 

• Allergic reactions: Although rare, allergic reactions to ethiodized oil can occur. It is important to monitor for any allergic reactions such as rash, itching, swelling, or difficulty breathing during and after administration. 
• Thyroid function: ethiodized oil can affect thyroid function and may interfere with the interpretation of thyroid function tests. Close monitoring of thyroid function is recommended, particularly in individuals with pre-existing thyroid conditions. 
• Bleeding tendencies: ethiodized oil can affect blood clotting, and caution should be exercised in individuals with bleeding disorders or those taking anticoagulant medications. Close monitoring for signs of bleeding or changes in coagulation parameters is recommended. 
• Pregnancy and lactation: The use of ethiodized oil during pregnancy and lactation should be done with caution.  
• Drug interactions: ethiodized oil may interact with certain medications, including anticoagulants and other iodine-containing substances.

Comorbidities: 

• Allergies: Individuals with a known allergy to ethiodized oil or iodine-containing substances may be at an increased risk of developing an allergic reaction. Special precautions and alternative options should be considered in these cases. 
• Thyroid disorders: ethiodized oil contains iodine, which can affect thyroid function. Individuals with pre-existing thyroid disorders, such as hypothyroidism or hyperthyroidism, may require close monitoring and appropriate management of their condition during the use of ethiodized oil. 
• Renal impairment: ethiodized oil is eliminated through the kidneys, so individuals with impaired renal function may experience difficulties in excreting the contrast agent. Dose adjustments or alternative imaging options may be necessary in such cases to minimize the risk of adverse effects. 
• Liver disease: ethiodized oil is metabolized by the liver, and individuals with liver disease may have impaired liver function. Close monitoring of liver function and cautious use of ethiodized oil are recommended in individuals with liver impairment. 

Pregnancy / Lactation

Pregnancy consideration: N/A 

Lactation: Excreted into human milk is known  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• <b>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: 

The pharmacology of ethiodized oil is primarily related to its iodine content. When injected into the bloodstream, ethiodized oil absorbs X-rays and attenuates the X-ray beam, leading to increased radiopacity in the areas where it is present. This enhances the visibility of blood vessels, organs, or other anatomical structures during imaging procedures. 

ethiodized oil is inert and has minimal pharmacological activity beyond its radiopaque properties. It does not significantly interact with body tissues or undergo metabolic transformations. It is gradually eliminated from the body through the hepatobiliary system and urinary excretion.  

Pharmacodynamics: 

The pharmacodynamics of ethiodized oil primarily involve its radiopaque properties and its interaction with X-rays during imaging procedures. When ethiodized oil is administered intravascularly or intraoperatively, it absorbs X-rays and attenuates the X-ray beam, leading to increased radiopacity in the areas where it is present. This enhanced radiopacity allows for better visualization of blood vessels, organs, or other anatomical structures during radiographic imaging. 

ethiodized oil does not have any direct pharmacological effects beyond its radiopaque properties. It does not interact with specific receptors or molecular targets in the body, nor does it alter physiological or biochemical processes. Its pharmacodynamic effects are limited to its role as a contrast agent, providing improved visibility during imaging procedures.  

Pharmacokinetics: 

Absorption 

ethiodized oil is typically administered through intravascular routes, such as intra-arterial or intravenous injection, or intraoperatively during surgical procedures. When administered intravascularly, it is rapidly distributed within the bloodstream. 

Distribution 

ethiodized oil has high lipophilicity, which allows it to distribute widely throughout the body. It is primarily taken up by tissues with high vascularity, such as the liver, spleen, and lymph nodes. Additionally, it can accumulate in tumors or abnormal blood vessels. 

Metabolism 

ethiodized oil is not significantly metabolized in the body. It undergoes minimal biotransformation or enzymatic breakdown. 

Elimination and excretion 

ethiodized oil is eliminated from the body primarily through the biliary system. It is excreted in the bile and ultimately eliminated in the feces. Renal excretion is minimal. 

Adminstartion

Administration: 

• Intra-arterial administration: ethiodized oil can be injected directly into an artery using angiographic techniques. This is commonly done during procedures such as hepatic arterial embolization or chemoembolization for the treatment of liver tumors. 
• Intravenous administration: ethiodized oil may be administered intravenously for certain diagnostic imaging procedures, such as lymphangiography or venography. It is injected into a vein to enhance visualization of blood vessels or lymphatic structures. 
• Intraoperative administration: During surgical procedures, ethiodized oil may be used to aid in visualization or localization of specific anatomical structures. The oil is typically applied or injected directly at the surgical site as directed by the surgeon. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: ethiodized oil 

Pronounced: (ee-thee-oh-dized oil)  

Why do we use ethiodized oil? 

• Radiographic imaging: ethiodized oil is used as a contrast agent in radiographic procedures to enhance visualization of certain body structures. It is particularly useful in imaging the liver, gallbladder, bile ducts, and lymphatic system. ethiodized oil helps to outline these structures and provide better visibility during imaging studies such as cholangiography, lymphangiography, or hysterosalpingography. 
• Therapeutic embolization: ethiodized oil can be used for therapeutic purposes, particularly in the treatment of liver tumors. In procedures such as hepatic arterial embolization (HAE) or transarterial chemoembolization (TACE), ethiodized oil is injected into the blood vessels supplying the tumor. It acts as an embolic agent, blocking the blood supply to the tumor and delivering chemotherapy agents directly to the tumor site. 
• Localization of lesions: ethiodized oil can be used to mark or localize lesions within the body. It is injected into or around the lesion to help the surgeon during surgical procedures.