Omnipac

Omnipaque is a radiopaque agent intended for diagnostic procedures.

Indications Omnipaca

It is used in contrast X-ray examinations of patients of different ages. The drug is used during cardioangiography procedures, kidney X-rays, arteriography with venography, and in addition to this, during CT, myelography in the neck, sternum or lumbar region, and arthrography.

In addition, the substance is used in ERCP, CT cisternography, as well as in examinations of the gastrointestinal tract and salpingography.

Release form

The substance is released in the form of a solution for intrathecal, intravascular, and intracavitary injections. The vials have a capacity of 10, 20, and also 50, 100 or 200 ml. The box contains 6, 10 or 25 such vials.

Pharmacodynamics

The radiopaque effect of the drug develops due to the absorption of X-rays by organically synthesized iodine. This effect provides visualization of blood vessels and tissue cavities on radiographs.

Pharmacokinetics

Intravenously administered iogexol is almost completely excreted by the kidneys within 24 hours, remaining unchanged. The Cmax values of the drug in the urine are noted after 60 minutes. The half-life of the substance with healthy renal function is 120 minutes. Metabolic products are not formed. The drug is almost not synthesized with protein (less than 2%).

After intrathecal administration, the drug penetrates the blood from the cerebrospinal fluid and is then excreted unchanged through the kidneys. The half-life is 3-4 hours.

Cavity contrast (uterine and joint cavities, pancreatic and biliary tract, bladder and fallopian tubes) develops almost immediately after the injection.

Dosing and administration

The method of administration and the portion size are selected taking into account many factors - the general condition of the person, the method of examination, age, weight and cardiac output.

The drug should be administered intravascularly during excretory urography (a type of X-ray contrast renal examination that evaluates the secretory activity of the kidneys), angiography, and also venography.

To perform excretory urography, an adult is administered 40-80 ml of a substance, 1 ml of which contains 0.3 or 0.35 g of iodine. A child weighing less than 7 kg is required to administer the drug in a ratio of 3 ml/kg (1 ml of the substance contains 0.3 g of iodine). A child weighing more than 7 kg is administered 2 ml/kg of a similar solution (maximum 40 ml).

To perform angiography of the aortic arch, 30-40 ml of the substance is used (0.3 g of iodine per 1 ml). When performing aortography (X-ray contrast examination of the shape of the aorta), 40-60 ml of the drug is administered (0.35 g of iodine per 1 ml). In the case of performing peripheral arteriography (X-ray examination of arteries) in the leg area, 30-50 ml of the drug is used (0.3 or 0.35 g of iodine per 1 ml of solution).

During cardioangiography (X-ray examination of the heart), 30-60 ml of a preparation containing 0.35 g of iodine per ml is injected into the aortic root and left ventricle of an adult. To perform selective coronary arteriography (X-ray examination of the heart arteries), 4-6 ml of a similar substance is required.

To perform leg venography, 20-100 ml of medication is used (0.24 or 0.3 g of iodine per 1 ml of liquid).

For intracavitary injections (arthrography, herniography, ERCP, X-ray examination of the pancreas by introducing drugs into the pancreas through the duodenum, as well as hysterosalpingography), Omnipaque is used, containing 0.24, 0.3 or 0.35 g of iodine in 1 ml - in a portion of 5-50 ml.

To perform an X-ray examination of the gastrointestinal tract, the substance is administered orally in portions of 10-200 ml (1 ml of the drug contains 0.18 g of iodine) or 10-20 ml (1 ml of the drug contains 0.35 g of iodine).

Subarachnoid administration is required for myelography of the thoracic, lumbar, and cervical regions (X-ray examination of the spinal cord regions - thoracic, lumbar, and cervical), and also for tomography in the region of the basal cisterns (X-ray examination of areas located on the base of the brain).

For adults, the medication is used in solutions, 1 ml of which contains 0.18, 0.24 or 0.3 g of iodine. For children - only substances containing 0.18 g of iodine in 1 ml. Taking into account medical indications, adult portions are within 4-15 ml, and children's - 2-12 ml. The total volume of iodine in the case of a subarachnoid injection can be a maximum of 3000 mg.

It is prohibited to mix the medicinal substance with solutions of other medicinal preparations.

After the procedure, it is necessary to provide the patient with the required hydration.

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Use Omnipaca during pregnancy

Omnipaque should not be prescribed during pregnancy. It should be used with caution in lactating women.

Contraindications

Among the contraindications:

• the presence of intolerance to the drug;
• hyperthyroidism;
• infections of a general or local nature;
• cerebral forms of infections;
• epileptic seizures (with subarachnoid injections).

Caution is required when prescribing in the following cases:

• epileptic seizures;
• diabetes mellitus;
• dehydration;
• hypertension affecting the lungs;
• elderly people;
• diseases in the cardiovascular system that are severe in nature;
• renal or hepatic insufficiency;
• chronic stage of alcoholism;
• myeloma disease;
• multiple sclerosis;
• thromboangiitis obliterans;
• severe form of atherosclerosis;
• thrombophlebitis in the acute stage;
• local allergy symptoms and general allergic pathologies.

Side effects Omnipaca

After intracavitary injection of the drug, vomiting, signs of allergy, a feeling of heat and nausea are occasionally observed.

In case of intrathecal injection, headaches, vomiting with nausea, paresthesia affecting the back with neck and limbs, as well as dizziness and convulsions (the latter in predisposed individuals) may occur.

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Overdose

If the drug is administered in a dosage of no more than 2 g/kg of iodine over a short period of time, the probability of poisoning is minimal.

Overdose symptoms include acidosis, bradycardia, and bleeding in the lungs, cyanosis, and cardiac arrest. In addition, there is a feeling of weakness, severe drowsiness or fatigue, convulsions, insomnia, and coma. Mental disorders are also possible: depression, severe hallucinations, or psychosis, fear, depersonalization, or disorientation. Amnesia, hypoesthesia, severe tremor, diplopia, or amblyopia, as well as photophobia, paralysis, speech or vision disorders, changes in EEG values, meningism, and cerebral hemorrhages are also noted.

In this regard, it is necessary to regularly monitor the functioning of vital systems and maintain normal EBV values. Emergency procedures are performed according to the indications.

Interactions with other drugs

It is prohibited to combine the drug with corticosteroids during intrathecal injections.

There is a pharmaceutical incompatibility (within the same syringe) between Omnipaque and antihistamines.

MAOIs, phenothiazine derivatives, CNS stimulants, tetracyclic antidepressants and analeptics increase the likelihood of developing seizures and epilepsy.

Antihypertensive medications, when combined with the drug, potentiate the likelihood of a decrease in blood pressure values.

Omnipaque potentiates the nephrotoxic effects of other medications.

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Storage conditions

Omnipaque must be kept at temperatures not exceeding 25°C.

Shelf life

Ominpak can be used within 36 months from the date of manufacture of the medicinal product.

Analogues

Analogues of the drug include such drugs as Ultravist, Unipak with Tomogexol, as well as Unigexol and Iogexol.

Reviews

In most reviews, Omnipaque is compared with other contrast agents (Urografin is mainly used for comparison). The latter is recommended to be used more often because it has a lower price. Although doctors and many patients mention that Omnipaque is significantly more tolerable. In this regard, medical professionals, if there is no reaction to the action of iodine, recommend using this drug.