Amidol Injection

Introduction

Amidol Injection 370 mg/ml is a contrast agent used in various radiological imaging procedures, including computed tomography (CT) scans and myelography. It is classified as a non-ionic, water-soluble iodinated contrast medium that helps enhance the visibility of internal structures in imaging studies.

Uses

Amidol Injection 370 mg/ml is used for:

Enhancing the contrast of blood vessels and tissues during CT imaging to assist in the diagnosis of various conditions, including tumors, vascular disorders, and internal injuries.
Improving visualization during myelography to evaluate the spinal cord, nerve roots, and surrounding structures.
Supporting angiographic procedures by highlighting vascular structures and blood flow.

Brand Name	Amidol
Type	Injection
Weight	370 mg/ml
Generic	Iopamidol
Manufacturer	Incepta Pharmaceuticals Ltd.
Available in	English বাংলা

Mechanism of Action

Amidol Injection 370 mg/ml works by increasing the contrast between tissues of differing densities in imaging studies. Its high iodine content absorbs X-rays more effectively than surrounding tissues, allowing for clearer imaging of blood vessels, organs, and other structures.

How Long Does It Take to Work?

The effects of Amidol Injection 370 mg/ml are immediate upon administration. It enhances imaging contrast within seconds to minutes, depending on the procedure and the area being imaged. The duration of the contrast effect generally lasts for the duration of the imaging study.

Absorption

Amidol Injection 370 mg/ml is administered directly into the body via injection or infusion, so systemic absorption is not a primary consideration. The contrast medium stays within the blood vessels or the area of interest during the imaging procedure.

Route of Elimination

Amidol Injection 370 mg/ml is primarily excreted through the kidneys. After imaging procedures, it is filtered from the blood and eliminated from the body in the urine. A small portion may be eliminated through the feces.

Dosage

Adult dosage:

Neurology: Lumber myelography: Iopamidol 370, 6-13 ml
Thoraco-cervical myelography: Iopamidol 370, 6-13 ml
Urography: Iopamidol 370, 40-80 ml IV up to 1.5 ml/kg in severe renal disease.

Children:

Usual Dose: 1-2.5 ml/kg
Other Diagnostic Procedure: Contrast enhancement in CT scanning: Iopamidol 370, 0.5-2.0 ml/kg

Angiography: Cerebral angiography: Iopamidol 370, 6-13 ml
Selective coronary arteriography: Iopamidol 370, 4-8 ml/artery
Peripheral arteriography: Iopamidol 370, 20-50 ml
Venography: Iopamidol 370, 24-60 ml
Angiocardiography: Iopamidol 370, 30-80 ml
Left ventriculography: Iopamidol 370, 30-80 ml
Percutaneous transfemoral or renal arteriography: Iopamidol 370, 30 ml
Selective renal arteriography: Iopamidol 370, 5-10 ml
Hepatic angiography: Iopamidol 370, 70 ml
Coeliac angiography: Iopamidol 370, 40-70 ml
Superior mesenteric angiography: Iopamidol 370, 25-50 ml
Inferior mesenteric angiography: Iopamidol 370, 5-30 ml
Digital subtraction angiography: 30-50 ml (10-20 ml/sec) of Iopamidol 370, IV 25 ml (left ventricle), 2-5 ml (coronary arteries), 15 ml/sec. of Iopamidol 370 i.a for cardiac imaging

The dosage of Amidol Injection 370 mg/ml varies depending on the imaging procedure:

CT Scans: Typically ranges from 50 to 150 mL, depending on the type of scan and the patient's body size.
Myelography: Usually requires 10 to 20 mL for adequate imaging.
Angiography: Doses vary widely, generally between 50 and 100 mL, based on the specific study and patient needs.

Dosages should be adjusted based on the patient's weight, the specific procedure, and the imaging requirements.

Administration

Amidol Injection 370 mg/ml is administered via intravenous injection or infusion, depending on the imaging procedure. For myelography, it is injected into the spinal canal. The administration is typically performed by a trained radiologist or healthcare professional.

Side Effects

Common side effects include:

Warm sensation or flushing during administration
Nausea
Headache
Dizziness

Serious side effects may include:

Allergic reactions (e.g., rash, itching, swelling, anaphylaxis)
Kidney problems (e.g., renal impairment)
Contrast-induced nephropathy

Toxicity

Toxicity of Amidol Injection 370 mg/ml is generally low when used as directed. Overdose or extravasation (leakage outside the blood vessels) can lead to local tissue damage or systemic effects. Symptoms of toxicity may include severe allergic reactions, kidney dysfunction, or significant discomfort at the injection site. Immediate medical attention is required for severe adverse reactions.

Precautions

Precautions include:

Assessing for any history of allergies or reactions to contrast media.
Monitoring renal function, especially in patients with pre-existing kidney conditions or diabetes.
Ensuring proper hydration before and after the procedure to help flush the contrast medium from the body.

Interaction

Amidol Injection 370 mg/ml may interact with:

Medications affecting kidney function: Such as diuretics or nephrotoxic drugs, which may increase the risk of contrast-induced nephropathy.
Other contrast agents: Careful consideration is needed to avoid excessive exposure to contrast media.

Disease Interaction

Use with caution in patients with:

Renal impairment or pre-existing kidney disease
Diabetes mellitus
Heart conditions or severe cardiovascular disease

Drug Interaction

Drug interactions with Amidol Injection 370 mg/ml include:

Metformin: Risk of lactic acidosis in patients with renal impairment. Metformin should be temporarily discontinued before and after imaging procedures.
Other nephrotoxic drugs: May increase the risk of contrast-induced nephropathy.

Food Interactions

There are no significant food interactions with Amidol Injection 370 mg/ml. However, maintaining adequate hydration before and after the imaging procedure is recommended.

Pregnancy Use

Amidol Injection 370 mg/ml is classified as pregnancy category C. It should be used during pregnancy only if the potential benefits outweigh the risks. The effects of Amidol Injection 370 mg/ml on fetal development are not well-studied, so it should be administered with caution and only if absolutely necessary.

Lactation Use

Amidol Injection 370 mg/ml is excreted in breast milk in small amounts. While it is generally considered safe for use during lactation, caution is advised. Monitor for any potential adverse effects in the nursing infant, and consult a healthcare provider if concerns arise.

Acute Overdose

In the event of an overdose or excessive exposure, symptoms may include severe allergic reactions, kidney dysfunction, or significant discomfort. Treatment involves discontinuing the contrast agent and providing supportive care. Hydration and monitoring of renal function are crucial.

Contraindication

Amidol Injection 370 mg/ml is contraindicated in patients with:

Known hypersensitivity to iodinated contrast media
Severe renal impairment or acute kidney injury
Severe dehydration

Use Direction

Use Amidol Injection 370 mg/ml as directed by a healthcare professional. Follow the instructions for administration and dosage based on the imaging procedure. Ensure pre-procedure assessment and hydration, and follow any post-procedure guidelines provided by the radiology team.

Storage Conditions

Store Amidol Injection 370 mg/ml at room temperature, between 15°C and 30°C (59°F and 86°F). Protect from light and avoid freezing. Keep the medication in its original container and out of reach of children.

Volume of Distribution

The volume of distribution for Amidol Injection 370 mg/ml is relatively low because it remains primarily within the vascular compartment and does not extensively distribute into tissues.

Half Life

The elimination half-life of Amidol Injection 370 mg/ml is approximately 2 to 3 hours. The contrast medium is rapidly cleared from the bloodstream and excreted through the kidneys.

Clearance

Amidol Injection 370 mg/ml is primarily cleared by the kidneys. The renal clearance rate is approximately 100 to 150 mL/min, and this may vary based on individual renal function and hydration status.

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