Universal reference book for medicines
Product name: OMNIPAKE (OMNIPAQUE)

Active substance: iohexol

Type: Radiopaque non-ionic diagnostic preparation for intravascular, intracavitary and subarachnoidal administration

Manufacturer: GE HEALTHCARE IRELAND (Ireland)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
X-ray contrast diagnostic non-ionic monomer.
Has low osmolarity. Yogexol is readily soluble in water, contains approximately 46.4% iodine.
Time to achieve maximum radiopaque in normal myelography - up to 30 minutes (after 1 h no longer visualized).
When CT is performed, visualization of the contrast in the thoracic region is possible within 1 hour, in the cervical region - about 2 hours, basal cisterns - 3-4 hours. Contrasting of the joint cavities, uterine cavity, fallopian tubes, peritoneal protrusions, pancreatic and biliary ducts, bladder is achieved immediately after administration.
PHARMACOKINETICS
After intravenous administration, C max is noted immediately after administration.
It is distributed in the extracellular fluid. Quickly accumulates in the kidneys: the contrast of the kidney passage begins 1 min after IV injection and reaches an optimum after 5-15 minutes. It binds to a small extent with plasma proteins and cerebrospinal fluid. It penetrates the placental barrier by simple diffusion. Does not penetrate intact GEB.
It is excreted by glomerular filtration in unchanged form (about 90% per 24 hours).

T 1/2 in the initial phase is about 20 minutes, inside and extravascular concentrations are equalized for 10 min, then the concentration decrease occurs exponentially with T 1/2 for about 2 hours. Kidney clearance is 120 min, total clearance is 131 ml / min, V d is 165 ml / kg.

After intrathecal administration, it is absorbed from the cerebrospinal fluid into the bloodstream and completely excreted by the kidneys (about 88% during the first day) unchanged.
Kidney clearance - 99 ml / min, total clearance - 109 ml / min. C max in blood plasma is achieved in 2-6 hours and is 119 μg / ml. V d is 157 ml / kg. T1/2 is 3.4 hours.
When ingestion increases the visualization of the gastrointestinal tract and is practically not absorbed (the kidneys are excreted 0.1-0.5%), absorption increases significantly in the presence of intestinal perforation or intestinal obstruction.

INDICATIONS
Intravascular application: angiography of the lungs, head, neck, brain, abdomen, kidneys;
angiocardiography, aortography, phlebography, urography; computed tomography (increase in resolution).
Subarachnoidal application: lumbar myelography, thoracic myelography, cervical myelography, computed tomography of basal cisterns.

Intracavitary application: arthrography, retrograde endoscopic pancreatography, retrograde endoscopic cholangiopancreatography, herniography, hysterosalpingography, sialogram.

Oral administration: GI research.

DOSING MODE
The dose is set individually, depending on the indications, age and body weight of the patient.

SIDE EFFECT
With intravascular application: nausea, vomiting, tenderness at the injection site, temporary fever, redness of the skin.

With subarachnoidal application (for myelography): headache, transient dizziness, pain in the back, neck, limbs, paresthesia, nausea, vomiting;
in isolated cases (in predisposed patients) - convulsions; a case of aseptic meningitis was registered.
CONTRAINDICATIONS
Pregnancy, hypersensitivity to iodine-containing contrast agents.

Subarachnoidal administration: epilepsy, technical failure in myelography (immediate re-examination is contraindicated), infectious diseases.

PREGNANCY AND LACTATION
Contraindicated in pregnancy.
If you need the use of yogexol during lactation, you should keep in mind the probability of minimal penetration into breast milk.
APPLICATION FOR FUNCTIONS OF THE LIVER
With caution apply for severe impairment of kidney function.

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
With caution apply for severe violations of liver function.

APPLICATION IN ELDERLY PATIENTS
Use with caution in old age.

SPECIAL INSTRUCTIONS
They are used with caution in case of anamnesis for allergic reactions to radiopaque agents, bronchial asthma, pollinosis, food allergy, thyrotoxicosis, myelomatosis, diabetes mellitus, severe liver and / or kidney dysfunction, dehydration, decompensated diseases of the cardiovascular system chronic heart failure, chronic alcoholism, multiple sclerosis, pheochromocytoma, sickle cell anemia, obliterating thromboangiitis (Burger's disease), acute thrombophlea
Fuck, expressed atherosclerosis, in old age, during lactation; when performing lumbar puncture with local or systemic infections.
In patients with an increased risk of developing allergic reactions, it is advisable to conduct preliminary therapy with GCS and / or antihistamines.

Consider the possibility of dehydration in patients with severe thyrotoxicosis, myelomatosis.

In patients with diabetes mellitus and a serum creatinine concentration greater than 500 μmol / L, the use of yogexol is only possible in cases of extreme necessity.

Careful observation of the patient is necessary if there is a suspicion of lowering the threshold of convulsive readiness.

After the application of yogexol, the iodo-binding ability of the thyroid tissue is reduced for a period of several days to 2 weeks.

DRUG INTERACTION
With the use of yogexol in patients receiving phenothiazine derivatives and other antipsychotics (neuroleptics), MAO inhibitors, tricyclic antidepressants, CNS stimulants, analeptics, the threshold of convulsive readiness decreases and the risk of epileptic seizures increases.

Antihypertensive drugs (including beta-adrenoblockers) increase the likelihood of developing arterial hypotension.

Yogexol enhances the nephrotoxic properties of other drugs.

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