Usage
Sodium diatrizoate is an iodinated, water-soluble, radiopaque contrast medium used in various radiographic imaging procedures. It’s prescribed for enhancing the visualization of internal organs and structures during X-rays, computed tomography (CT) scans, angiography, urography, and gastrointestinal (GI) studies. It’s classified as a radiological/contrast media.
Sodium diatrizoate works by increasing the radiodensity of the targeted areas. The iodine in the compound absorbs X-rays, resulting in those areas appearing brighter or whiter on the image, thereby creating a contrast that helps delineate the structures being examined. It’s minimally absorbed from the GI tract when administered orally or rectally.
Alternate Names
Sodium diatrizoate is also known as amidotrizoate. It is often combined with meglumine diatrizoate. Popular brand names include Hypaque Sodium, Gastrografin (combination with meglumine diatrizoate), MD-Gastroview (combination with meglumine diatrizoate), Urografin (combination with meglumine diatrizoate) and others.
How It Works
Pharmacodynamics: Sodium diatrizoate’s primary effect is to opacify the target area during imaging procedures. Its high iodine content facilitates greater X-ray absorption, leading to enhanced contrast on the resulting image. When administered orally or rectally, it has a mild laxative effect due to hyperosmolality.
Pharmacokinetics:
- Absorption: Minimally absorbed from the intact GI tract when administered orally or rectally. When given intravenously it quickly distributes throughout the extracellular fluid.
- Metabolism: Not metabolized.
- Elimination: Excreted primarily via the kidneys through glomerular filtration. Some elimination occurs via the liver and biliary system into feces. When absorbed systemically, some diatrizoate is excreted in breast milk.
Mode of Action: The iodine component absorbs X-rays, increasing the radiopacity of the targeted organ or structure. This mechanism doesn’t involve receptor binding, enzyme inhibition, or neurotransmitter modulation. It’s purely a physical interaction with X-rays.
Dosage
Sodium diatrizoate dosage depends on the specific procedure, the patient’s age and weight, and their renal function. The information below is for general guidance only. Always consult the specific product labeling and consider patient-specific factors.
Standard Dosage
Adults:
- Oral/Rectal: 30 to 90 mL, depending on the examination.
- Intravenous/Intra-arterial: varies greatly depending on the procedure; ranges from 15 to 160 ml, or higher in some cases.
Children:
- Oral/Rectal:
- Infants and Children up to 5 years: 30 mL (may be diluted).
- Children 5 to 10 years: 60 mL (may be diluted).
- Intravenous/Intra-arterial: Safety and efficacy not fully established in children under 16, specific dosage varies depending on the procedure.
Special Cases:
- Elderly Patients: Use with caution; consider dilutions, especially in cachectic patients.
- Patients with Renal Impairment: Use with caution; reduced doses or alternative imaging methods may be considered.
- Patients with Hepatic Dysfunction: Use caution in patients with combined hepatic and renal disease.
- Patients with Comorbid Conditions: Evaluate patient condition to assess benefit vs risk.
Clinical Use Cases
Dosage varies greatly depending on the specific procedure and patient characteristics. Always consult specific product information and adapt to the clinical context.
Dosage Adjustments
Adjustments required based on the examination, patient age, weight, renal function, and other factors.
Side Effects
Common Side Effects
Nausea, vomiting, diarrhea, flushing, warmth sensation, headache, dizziness.
Rare but Serious Side Effects
Allergic reactions (ranging from mild rash and hives to severe anaphylaxis), kidney problems, hypotension, cardiac arrhythmias, hypothyroidism (especially in neonates), blood in urine, seizures, difficulty breathing or swallowing.
Long-Term Effects
Generally, not intended for long-term use.
Adverse Drug Reactions (ADR)
Severe allergic reactions, acute renal failure, cardiac arrest, seizures.
Contraindications
Hypersensitivity to diatrizoate or any component of the formulation, severe renal or hepatic dysfunction, anuria, concurrent use with metformin (especially in patients with renal impairment), and known hypersensitivity to iodine.
Drug Interactions
Metformin (increased risk of lactic acidosis and renal failure), other nephrotoxic drugs, and medications that can affect thyroid function (e.g., antithyroid drugs).
Pregnancy and Breastfeeding
- Pregnancy: Use only if clearly needed. Risk to the fetus is not fully understood but animal studies have not shown teratogenic effects.
- Breastfeeding: Excreted in breast milk. Consider interrupting breastfeeding for 24 hours after administration.
Drug Profile Summary
- Mechanism of Action: Provides radiographic contrast by absorbing X-rays due to its iodine content.
- Side Effects: Nausea, vomiting, diarrhea, flushing, allergic reactions, kidney problems.
- Contraindications: Hypersensitivity to diatrizoate or iodine, severe renal/hepatic dysfunction, concurrent use with metformin.
- Drug Interactions: Metformin, nephrotoxic drugs.
- Pregnancy & Breastfeeding: Use with caution if clearly needed during pregnancy; interrupt breastfeeding for 24 hours after administration.
- Dosage: Varies depending on the procedure and patient characteristics.
- Monitoring Parameters: Renal function, vital signs, allergic reactions.
Popular Combinations
Often combined with meglumine diatrizoate (e.g., Gastrografin, MD-Gastroview, Urografin). Some products include simethicone, flavoring agents, and preservatives.
Precautions
Evaluate hydration status, renal and hepatic function, and history of allergies. Careful attention to dosage and dilution in infants, young children, and debilitated patients is crucial.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Sodium Diatrizoate?
A: The dosage is highly dependent on the specific procedure, patient age, weight, and renal function. Consult the product’s prescribing information and adjust accordingly.
Q2: What are the primary uses of Sodium Diatrizoate?
A: It’s used as a contrast agent in various radiographic procedures like X-rays, CT scans, angiography, urography, and GI studies.
Q3: How does Sodium Diatrizoate work?
A: It enhances image contrast by absorbing X-rays due to its high iodine content.
Q4: What are the common side effects?
A: Common side effects include nausea, vomiting, diarrhea, flushing, and a sensation of warmth.
Q5: What are the serious side effects?
A: Serious side effects include allergic reactions (including anaphylaxis), renal impairment, hypotension, and cardiac arrhythmias.
Q6: Can it be used in pregnant or breastfeeding women?
A: It should be used with caution during pregnancy, only if the benefits outweigh the risks. Breastfeeding should be interrupted for 24 hours after administration.
Q7: What are the contraindications?
A: Contraindications include hypersensitivity to diatrizoate, severe renal/hepatic impairment, concurrent use with metformin (especially in renal impairment), and anuria.
Q8: Does Sodium Diatrizoate interact with any other medications?
A: It can interact with metformin, increasing the risk of lactic acidosis and renal impairment. It can also interact with nephrotoxic drugs.
Q9: What precautions should be taken before administering Sodium Diatrizoate?
A: Evaluate the patient’s hydration status, renal and hepatic function, and any history of allergies. Use caution and appropriate dilutions in infants, young children, elderly or debilitated patients.
Q10: What are the different routes of administration for Sodium Diatrizoate?
A: It can be administered orally, rectally, intravenously, and intra-arterially, depending on the specific diagnostic procedure.
