Pamirei

Pamirei is a medical radiopaque substance containing iodine. International name: Iopamidol. Other trade names: Iopamidol, Iopamiro, Iopamiron, Niopam, Tomoscan, Scanlux.

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Indications Pamirei

The drug is used for diagnostic purposes during such X-ray examinations as angiography of the cardiovascular system, including the brain; peripheral arteriography; coronary angiography and ventriculography; angiocardiography; selective visceral arteriography and retrograde aortography; peripheral venography (phlebography); lumbar and thoracocervical myelography; intravenous urography.

It is also used to enhance the contrast of images during computer tomography of various systems and organs. Pamirei can be useful for detecting and determining the size of malignant neoplasms such as glioblastomas, astrocytomas, oligodendrogliomas, medulloblastomas, meningiomas, neurinomas, pituitary adenomas, craniopharyngiomas, and their metastatic lesions.

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Release form

Release form: injection solution in 50 and 100 ml vials.

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Pharmacodynamics

The mechanism of action of this substance is based on the ability of iodine, which is part of it, to absorb X-rays. Due to this, the contrast of the X-ray image of the vascular bed is enhanced and the quality of its visualization is improved.

Pamirei is a water-soluble non-ionic radiopaque agent that does not increase the osmotic concentration of blood plasma. One milliliter of solution contains 612.4 mg or 755.2 mg of organically bound iodine. The pH value at 6.5-7.5 is adjusted using hydrochloric acid and sodium hydroxide. Due to the absence of ions, the active substance iopamidol has a less pronounced toxic effect and significantly improves the tolerability of the drug, reducing the risk of possible complications.

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Pharmacokinetics

When the drug is administered into the vessels, it enters the blood plasma, slightly binding to its albumin, fibrinogen and lipoproteins, does not penetrate cell membranes, and partially penetrates the blood-brain barrier.

Over the next 24 hours, the entire volume of Pamirei circulates in the bloodstream, but after 48 hours the blood is completely free of the drug.

Pamirei is a urotropic drug: it is excreted in urine by glomerular filtration of the kidneys; metabolites are absent. Complete elimination can last 3-4 days.

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Dosing and administration

The method of application of this radiocontrast agent is intravenous or intraarterial injection (depending on the nature of the diagnostic procedure).

The specific dosage depends on: the type of examination, the patient's age and body weight, the state of the cardiovascular system and kidneys. The drug has a maximum permissible dose in a volume not exceeding 250 ml.

For angiography, lumbar and thoracocervical myelography, the dose ranges from 5 to 10 ml; for phlebography and urography, 30-50 ml is administered; for angiocardiography, coronary angiography, aortography of the thoracic or abdominal cavity, the dose is determined based on 1 ml of the drug per kilogram of body weight.

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Use Pamirei during pregnancy

The use of Pamirs during pregnancy is prohibited.

Contraindications

Pamirei is contraindicated for use in cases of suspected or existing hypersensitivity to iodine and other components of the product, in cases of increased production of thyroid hormones (hyperthyroidism and thyrotoxicosis), in cases of liver or kidney failure, in cases of blood cancer in the form of multiple myeloma, as well as in cases of malignant proliferation of plasma cells in the blood that produce macroglobulins (Waldenstrom's macroglobulinemia).

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Side effects Pamirei

Side effects that occur after the administration of Pamirei are expressed in symptoms such as:

• a feeling of heat and cold throughout the body, chills;
• headache and dizziness;
• taste disturbance;
• increase in general body temperature;
• skin reaction in the form of a small rash, spots or papules;
• nausea and vomiting;
• muscle tremors, convulsions;
• change in blood pressure;
• increased heart rate;
• shortness of breath, bronchospasm.

The possibility of developing pulmonary edema, vascular collapse and anaphylactic shock is not excluded; with cerebral angiography – paresis, stupor, comatose state.

Since, like all iodine-containing contrast agents, Pamirei may cause severe or fatal reactions, patients should have easy access to their veins during the examination to provide emergency care, and the necessary resuscitation equipment and appropriate medications should be available.

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Overdose

Overdose is manifested by a significant increase in side effects. To eliminate the consequences of exceeding the dosage, symptomatic treatment should be carried out; hemodialysis gives good results.

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Interactions with other drugs

The simultaneous use of Pamirei with analgesic, neuroleptic and analeptic drugs, as well as with tricyclic antidepressants leads to the occurrence and intensification of seizures.

In patients with chronic diabetic nephropathy taking the hypoglycemic drug Metformin, kidney function temporarily worsens and the elimination of lactic acid and poly-p-hydroxybutyric acid from the body is slowed, leading to diabetic acidosis.

Beta-blockers used for hypertension and cardiac arrhythmia, in combination with Pamir, lead to an immediate allergic reaction in the form of an anaphylactic state.

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Storage conditions

Storage conditions for Pamirei: in the original packaging, in a dark place, at a temperature not exceeding +25°C.

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Shelf life

The shelf life in the original packaging is 36 months. After opening the bottle, Pamirei is used immediately, unused remains are destroyed.