Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

Gomi, Tatsuya; Nagamoto, Masashi; Hasegawa, Makoto; Katoh, Asako; Sugiyama, Miki; Murata, Naoki; Kunihiro, Toshiyuki; Kohda, Ehiichi

doi:10.1007/s00330-009-1698-6

Cited by 53 publications

(40 citation statements)

References 13 publications

(21 reference statements)

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“…Sutton et al also reported that visipaque is well tolerated in the early phase of injection (6). In a study by Gomi et al, immediate reaction was reported in 2.7 % in iodixanol in comparison with 3.5 % in iopromide (7). Skin reaction is mostly mild skin reaction which will be resolved simply.…”

Section: Discussionmentioning

confidence: 98%

Comparison of Allergic Adverse Effects and Contrast Enhancement Between Iodixanol and Iopromide

Gharekhanloo

Torabian

2012

Iran J Radiol

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BackgroundIodinated X-ray contrast media are the most commonly used contrast agents in the world with an annual application of 40-50 million. New non-ionic contrast agents are subdivided into low osmolar agents such as iopromide and iso-osmolar agents such as iodixanol. Regarding different biochemical characteristics, these agents are different in the allergic reactions and contrast enhancement and final lesion conspicuity.ObjectivesThis study was carried out to compare allergic adverse effects and contrast enhancement between iodixanol and iopromide.Patients and MethodsOne-hundred and twenty patients who were referred for abdominal CT scan to Besat Hospital were included in this study. Patients were randomly divided into two groups (A and B). Group A received 100 cc iodixanol (300 mgI/mL) and group B received 100 cc iopromide (300 mgI/ml) by power injector. CT examination was performed using Helical CT Scanner (Somatom, Siemens, Germany). Sixty seconds after injection, images were obtained and enhancement of port, liver and aorta were determined. Allergic adverse effects were recorded one hour and up to one week after injection.ResultsIodixanol produced a significantly greater enhancement of the hepatic, aorta and portal vein than iopromide (P < 0.01). Sixty seconds after injection, associated pain and heat sensation were less frequent in iodixanol in comparison with iopromide (P = 0.03). Immediate reactions such as nausea and vomiting were less frequent in iodixanol (P = 0.01). Late skin reactions such as rash was more frequent in iodixanol (P < 0.01).ConclusionsIodixanol is safe and is better tolerated in the early phase of injection with better contrast enhancement and lesion conspicuity. Mild late skin rash is its disadvantage.

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Section: Discussionmentioning

confidence: 98%

Comparison of Allergic Adverse Effects and Contrast Enhancement Between Iodixanol and Iopromide

Gharekhanloo

Torabian

2012

Iran J Radiol

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“…Recently, Gomi, et al conducted a prospective study in a large population, unlike previous studies. They reported that iopromide had a higher incidence of adverse reactions compared to other RCM products (including iopamidol, iohexol, and ioversol) . Additionally, Seong et al evaluated 6624 adverse reactions to low‐osmolar RCMs.…”

Section: Discussionmentioning

confidence: 99%

Varied incidence of immediate adverse reactions to low‐osmolar non‐ionic iodide radiocontrast media used in computed tomography

Kim

Lee

Park

et al. 2016

Clin Experimental Allergy

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SummaryBackground Low-osmolar non-ionic radiocontrast media (RCMs) are commonly used throughout hospitals. However, the incidence of immediate adverse drug reactions (ADRs) to various low-osmolar non-ionic RCMs is not well studied. We compared the incidence of immediate ADRs among different low-osmolar non-ionic RCMs used in computed tomography (CT). Methods Severance Hospital has collected data for adverse reactions occurring in-hospital using an internally developed system. Using this data, we reviewed 1969 immediate ADRs from 286 087 RCM-contrasted CT examinations of 142 099 patients and compared the immediate ADRs of iobitridol, iohexol, iopamidol, and iopromide. We analysed the incidence of immediate ADRs to different RCMs, as well as the effect of single or multiple CT examinations per day. Results Iopromide showed the highest incidence of immediate ADRs (1.03%) and was followed by iopamidol (0.67%), iohexol (0.64%), and iobitridol (0.34%). In cases of anaphylaxis, iopromide also showed the highest incidence (0.041%), followed by iopamidol (0.023%), iohexol (0.018%), and iobitridol (0.012%). Risk of immediate ADR due to multiple CT examinations (1.19%) was significantly higher than the risk due to a single CT examination (0.63%). Risk of anaphylaxis was also higher for multiple CT examinations (0.052%) than for a single CT examination (0.020%). Conclusions and Clinical Relevance The incidence of immediate ADRs varied according to the low-osmolar non-ionic RCM used. Iopromide-induced immediate ADRs were more frequent, while iobitridol was associated with fewer immediate ADRs than other RCMs. Multiple CT examinations per day resulted in a higher incidence of immediate ADRs and anaphylaxis than a single CT examination. Clinicians should consider these risk differences of immediate ADRs when prescribing contrasted CT examinations.

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“…Although LOCM have very similar molecular structures, the individual media have different safety profiles. Gomi et al (22) found that the proportion of patients experiencing AE varied by LOCM (iomeprol, 3.9%; iopamidol, 2.2%; iohexol, 2.0%; iopromide, 3.5%; ioversol, 1.8%; and all five combined, 2.7%) among the 8,931 patients who underwent contrast-enhanced CT. However, to our knowledge, this is the first study specifically designed to compare the frequency of AEs of iodinated contrast media by organ class between individual media, as well as between low-osmolar and iso-osmolar media.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Safety of Seven Iodinated Contrast Media

et al. 2013

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We aimed to determine the characteristic adverse events (AEs) of iodinated contrast media (IOCM) and to compare the safety profiles of different IOCM. This study used the database of AEs reports submitted by healthcare professionals from 15 Regional Pharmacovigilance Centers between June 24, 2009 and December 31, 2010 in Korea. All reports of IOCM, including iopromide, iohexol, iopamidol, iomeprol, ioversol, iobitridol and iodixanol, were analyzed. Safety profiles were compared between different IOCM at the system organ level using the proportional reporting ratio (PRR) and 95% confidence interval (95% CI). Among a total of 48,261 reports, 6,524 (13.5%) reports were related to the use of IOCM. Iopromide (45.5%), iohexol (16.9%), iopamidol (14.3%) and iomeprol (10.3%) were identified as frequently reported media. 'Platelet, bleeding & clotting disorders' (PRR, 29.6; 95%CI, 1.9-472.6) and 'urinary system disorders' (PRR, 22.3; 95% CI, 17.1-29.1) were more frequently reported for iodixanol than the other IOCM. In conclusion, the frequency of AEs by organ class was significantly different between individual media. These differences among different IOCM should be considered when selecting a medium among various IOCM and when monitoring patients during and after its use to ensure optimum usage and patient safety.

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Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

Abstract: The incidence of acute adverse reactions may be reduced in younger patients by using iopamidol, iohexol and ioversol.

Cited by 53 publications

References 13 publications

Comparison of Allergic Adverse Effects and Contrast Enhancement Between Iodixanol and Iopromide

Comparison of Allergic Adverse Effects and Contrast Enhancement Between Iodixanol and Iopromide

Varied incidence of immediate adverse reactions to low‐osmolar non‐ionic iodide radiocontrast media used in computed tomography

Comparison of the Safety of Seven Iodinated Contrast Media

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