CAS Number 737-31-5 DrugBank DB00271 | PubChem CID 2140 | |
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Trade names Hypaque, Gastrografin, Iothalmate, Urografin, others AHFS/Drugs.com Micromedex Detailed Consumer Information Synonyms amidotrizoic acid, diatrizoic acid, 3,5-diacetamido-2,4,6-triiodobenzoic acid | ||
Diatrizoate, also known as amidotrizoate, is a contrast agent used during X-rays. This includes when visualizing veins, the urinary system, spleen, and joints, as well as during computer tomography (CT scan). It is given by mouth, injection into a vein, injection into the bladder, or rectally.
Contents
Relatively common side effects include vomiting, diarrhea, and skin redness. Other side effects include itchiness, kidney problems, low blood pressure, and allergic reactions. It is not recommended in people who have an iodine allergy. Diatrizoate is an iodinated ionic radiocontrast agent with high osmolality.
Diatrizoate was approved for medical use in the United States in 1954. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about 5.49 USD per 20 ml vial. In the United States a dose costs less than 25 USD.
Medical uses
Diatrizoic acid may be used as an alternative to barium sulfate for medical imaging of the gastrointestinal tract, such as upper gastrointestinal series and small bowel series. It is indicated for use in patients who are allergic to barium, or in cases where the barium might leak into the abdominal cavity. It does not coat the stomach/bowel lining as well as barium, so it is not used commonly for this purpose.
It is used for intravenous pyelography.
It is also used to treat Ascaris lumbricoides (roundworms). Diatrizoate may not actually kill Ascaris, but instead it promotes shifting of fluid in the bowel lumen, so may relieve intestinal obstruction caused by impacted Ascaris.
Administration
Contraindications
A history of sensitivity to iodine is not a contraindication to using diatrizoate, although it suggests caution in use of the agent. In this case, a regimen of oral or intravenous corticosteroids may be given as prophylaxis, or an alternative such as barium sulfate may be preferable.
Gastrografin is contraindicated to use along with certain medications that can cause lactic acidosis, such as metformin. Concurrent use may lead to renal failure and lactic acidosis, and a clinician may need to space the agents apart over a number of days to prevent an interaction.
Gastrografin is a hypertonic solution, and therefore it should be avoided in imaging studies of the upper gastrointestinal tract in patients who are at risk of aspiration, as it will cause prompt pulmonary edema if accidentally introduced into the tracheobronchial tree.
Urografin is not to be used for myelography, ventriculography or cisternography, since it is likely to provoke neurotoxic symptoms in these examinations.
Chemistry
Diatrizoate is considered a high-osmolality contrast agent. Its osmolality ranges from approximately 1500 mOsm/kg (50% solution) to over 2000 mOsm/kg (76% solution).
Brand names
Hypaque, Gastrografin, Iothalmate, and Urografin. Urografin is a combination of the sodium and meglumine salts.