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

Abstract

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.

A study on adverse drug reactions to non-ionic contrast medium in an Indian population: a 1-year experience

“…In a recent study conducted by Gharekhanloo and Torabian in Iran on new non-ionic contrast agents, 17 mostly mild skin reactions, nausea and vomiting were observed which could be resolved simply. In our study also most reactions were mild in nature (54.54%).…”

Frequency and Severity of Acute Adverse Effects of Low Osmolar Iodinated Contrast Media in Contrast-Enhanced Computed Tomography

“…It is necessary to be aware of the possibility of adverse reactions against these compounds ranging from mild aggravations to life-threatening crisis 11 . The immediate/acute reaction occurs up to one-hour post injection and is related to the osmotic load or contrast media chemotoxicity 12 . These acute adverse reactions are of clinical concern because they are uncertain and cause discomfort to patients.…”

Avaliação das reações adversas ao uso de contrastes em exames de diagnóstico por imagem

“…As reações encontradas foram principalmente cutâneas (incluindo coceira/prurido e edema). [17][18][19] Outro estudo demonstrou que o contraste mais utilizado em exames de imagem é o iopromide (45,5%), e o mesmo teve maior prevalência (54,2%) de efeitos adversos se comparado aos demais, bem como em relação ao contraste iso-osmolar (iodixanol), cuja prevalência foi de apenas 7,6%. Todavia, o mesmo estudo demonstrou uma elevada prevalência de efeitos adversos no trato urinário de pacientes que utilizaram o iodixanol e desta forma, mesmo que o mesmo seja mais recomendado em algumas situações, ele pode ter um componente nefrotóxico a ser elucidado.…”