Diapac IV Injection

Introduction

Diapac IV Injection 350 mg/ml is a non-ionic, water-soluble radiographic contrast medium. It is used to enhance the visibility of various body structures during imaging procedures such as computed tomography (CT) scans, angiography, and other X-ray-based diagnostic tests. Diapac IV Injection 350 mg/ml contains iodine, which helps to absorb X-rays and improves the contrast of the images.

Uses

Diapac IV Injection 350 mg/ml is used in:

Angiography: To visualize blood vessels in the heart, brain, kidneys, and other areas.
CT Scans: To enhance the contrast of tissues and organs during computed tomography imaging.
Myelography: To visualize the spinal cord and surrounding tissues.
Urography: To evaluate kidney function and urinary tract abnormalities.

Brand Name	Diapac
Type	IV Injection
Weight	350 mg/ml
Generic	Iohexol
Manufacturer	Techno Drugs Ltd.
Available in	English বাংলা

Mechanism of Action

Diapac IV Injection 350 mg/ml enhances imaging by increasing the density of tissues in which it accumulates due to its iodine content. Iodine absorbs X-rays, making these tissues appear whiter on the radiograph or CT image, thereby providing a clearer contrast between different structures.

How Long Does It Take to Work?

Diapac IV Injection 350 mg/ml begins to work immediately after injection, with peak contrast effects typically observed within minutes. The timing depends on the imaging procedure and the route of administration.

Absorption

When administered intravenously or intra-arterially, Diapac IV Injection 350 mg/ml is rapidly distributed throughout the vascular system. It is not absorbed when given intrathecally (injected into the spinal canal) or used for intra-articular (joint) injections.

Route of Elimination

Diapac IV Injection 350 mg/ml is primarily eliminated through the kidneys via glomerular filtration. It is excreted unchanged in the urine, with more than 90% eliminated within 24 hours after administration.

Dosage

Injection As iohexol soln containing 6-350 mg iodine/mL: Dose and strength used depends on the procedure and route of administration.

Injection-

Angiocardiography:

Adult: Ventriculography: 350 mg iodine/ml: 30-60 ml, usual: 40 ml, may be repeated as necessary. If with selective coronary arteriography: max 250 ml. Selective coronary arteriography: 350 mg iodine/ml: 3-14 ml per inj, usual: 5 ml. Aortic root and arch study when used alone: 350 mg iodine/ml: 20-75 ml, usual 50 ml. Multiple procedures: 350 mg iodine/ml: max 250 ml.
Child: Ventriculography: 350 mg iodine/ml: 1-1.5 ml/kg, usual: 1.25 ml/kg; 300 mg iodine/ml: 1.5-2 ml/kg, usual 1.75 ml/kg. Max: 5 ml/kg; 350 mg iodine/ml: 250 ml; 300 mg iodine/ml: 291 ml. Pulmonary angiography: 350 mg iodine/ml: 1 ml/kg. Multiple procedures: Max: 5 ml/kg; 350 mg iodine/ml: 250 ml; 300 mg iodine/ml: 291 ml.

Aortography and selective visceral arteriography

Adult: Use 300 or 350 mg iodine/ml solution, single inj. Aorta: 50-80 ml; major branches: 30-60 ml; renal arteries: 5-15 ml. Repeat as necessary. Max: 300 mg iodine/ml: 291 ml; 350 mg iodine/ml: 250 ml.
Child: Use 350 mg iodine/ml solution: 1 ml/kg, single dose. Max: 5 ml/kg up to 250 ml.

Voiding cystourethrography:

Adult: Use diluted solutions using sterile water for inj to concentrations of 50-100 mg iodine/ml. Usual volume: 50 mg iodine/ml solution: 50-600 ml; 100 mg iodine/ml: 50-300 ml.
Child: Children: Use diluted solutions using sterile water for inj to concentrations of 50-100 mg iodine/ml: 50-300 ml.

Hysterosalpingography:

Adult: 240 mg iodine/ml: 15-20 ml; 300 mg iodine/ml: 15-20 ml.

Arthrography:

Adult: Knee: 240 mg iodine/ml: 5-15 ml; 300 mg iodine/ml: 5-15 ml; 350 mg iodine/ml: 5-10 ml. Shoulder: 240 mg iodine/ml: 3 ml; 300 mg iodine/ml: 10 ml. Temporomandibular: 300 mg iodine/ml: 0.5-1 ml. Lower volumes are recommended for double-contrast examinations; higher volumes are recommended fro single-contrast examinations.

Herniography:

Adult: 240 mg iodine/ml: 50 ml.

Excretory urography:

Adult: Use 300 or 350 mg iodine/ml solution: 200-350 mg iodine/kg.
Child: Use 300 mg iodine/ml solution: 0.5-3 ml/kg, usual: 1-1.5 ml/kg; max: 3 ml/kg.

Endoscopic retrograde cholangiopancreatography (ERCP), Endoscopic retrograde pancreatography (ERP):

Adult: Use 240 mg iodine/ml: 10-50 ml.

Intra-arterial-

Peripheral arteriography:

Adult: Aortofemoral runoffs: 350 mg iodine/ml: 20-70 ml; 300 mg iodine/ml: 30-90 ml. Selective arteriograms (femoral/iliac): 350 mg iodine/ml: 10-30 ml; 300 mg iodine/ml: 10-60 ml. Venography (per leg): 240 mg iodine/ml: 20-150 ml; 300 mg iodine/ml: 40-100 ml.

Cerebral arteriography:

Adult: Use 300 mg iodine/ml solution: Common carotid artery: 6-12 ml; internal carotid artery: 8-10 ml; external carotid artery: 6-9 ml; vertebral artery: 6-10 ml.

Digital subtraction angiography:

Adult: Use 140 mg iodine/ml solution: Aorta: 20-45 ml at 8-20 ml/sec; carotid: 5-10 ml at 3-6 ml/sec; femoral: 9-20 ml at 3-6 ml/sec; vertebral: 4-10 ml at 2-8 ml/sec; renal: 6-12 ml at 3-6 ml/sec; other branches of the aorta (includes subclavian, axillary, innominate and iliac): 8-25 ml at 3-10 ml/sec.

Intrathecal-

Contrast-enhanced computerized tomography:

Adult: Lumbar (via lumbar inj): 180 mg iodine/ml: 10-17 ml; 240 mg iodine/ml: 7-12.5 ml. Thoracic (via lumbar or cervical inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 6-10 ml. Cervical (via lumbar inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml solution: 6-10 ml. Cervical (via C1-2 inj): 180 mg iodine/ml: 7-10 ml; 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 4-10 ml. Total columnar (via lumbar inj): 240 mg iodine/ml: 6-12.5 ml; 300 mg iodine/ml: 6-10 ml.
Child: Use 180 mg iodine/ml solution. 0-<3 mth: 240 ml; 3-<36 mth: 4-8 ml; 3-<7 yr: 5-10 ml; 7-<13 yr: 5-12 ml; 13-18 yr: 6-15 ml.

Intravenous-

Contrast-enhanced computerized tomography of the abdomen:

Adult: In conjunction with dilute oral admin, use 300 mg iodine/ml solution: 100-150 ml. The oral dose is administered 20-40 min prior to IV dose and image acquisition.
Child: In conjunction with dilute oral admin, use 240 or 300 mg iodine/ml solution: 1-2 ml/kg; max 3 ml/kg. The oral dose is administered 30-60 min prior to IV dose and image acquisition.

Digital subtraction angiography:

Adult: 350 mg iodine/ml: 30-50 ml, as a bolus at 7.5-30 ml/second using a pressure injector, usually for 3 or more inj; max: 250 ml.

Contrast-enhanced computerized tomography:

Adult: Head imaging by inj: 300 mg iodine/ml: 70-150 ml; 350 mg iodine/ml: 80 ml. Head imaging by infusion: 240 mg iodine/ml: 120-250 ml. Body imaging by inj: 300 mg iodine/ml: 50-200 ml; 350 mg iodine/ml: 60-100 ml.
Child: Head imaging: 240 or 300 mg iodine/ml: 1-2 ml/kg. Max: 28 g iodine with 240 mg iodine/ml solution or 35 g iodine with 300 mg iodine/ml solution.

The dosage of Diapac IV Injection 350 mg/ml depends on the type of procedure, the route of administration, and the patient's clinical condition. General guidelines are:

CT Imaging: 1.2-2.0 mL/kg body weight (300 mg iodine/mL).
Angiography: 5-10 mL of 300 mg iodine/mL for coronary arteries, or higher for larger vessels.
Myelography: 10-15 mL of 240-300 mg iodine/mL for lumbar or thoracic imaging.

The exact dosage is determined by the radiologist based on the imaging needs.

Administration

Diapac IV Injection 350 mg/ml is administered by trained healthcare professionals via intravenous, intra-arterial, intrathecal, or intra-articular routes, depending on the imaging procedure. It should be injected slowly and under sterile conditions to avoid complications.

Side Effects

Common side effects of Diapac IV Injection 350 mg/ml include:

Warm or flushed sensation
Mild nausea or vomiting
Headache
Dizziness
Temporary changes in taste

Rare but serious side effects include allergic reactions, kidney damage, or seizures (especially with intrathecal use).

Toxicity

Diapac IV Injection 350 mg/ml is generally well-tolerated, but excessive doses can lead to nephrotoxicity (kidney damage), especially in patients with pre-existing renal impairment. Signs of toxicity include worsening renal function, dehydration, or severe allergic reactions (anaphylaxis).

Precautions

Patients should be monitored closely if they have:

Kidney disease or poor renal function
Dehydration
Heart disease or heart failure
A history of iodine allergy or hypersensitivity to contrast media

Hydration before and after the procedure can help reduce the risk of kidney damage.

Interaction

Diapac IV Injection 350 mg/ml may interact with:

Metformin: Increases the risk of lactic acidosis in patients with kidney impairment.
Diuretics: May increase the risk of dehydration and nephrotoxicity.
Nephrotoxic drugs: Concurrent use with nephrotoxic agents (e.g., aminoglycosides) increases the risk of kidney damage.

Disease Interaction

Diapac IV Injection 350 mg/ml should be used cautiously in patients with:

Renal impairment
Cardiovascular diseases
Diabetes (due to interaction with Metformin)
Hyperthyroidism

Drug Interaction

Diapac IV Injection 350 mg/ml can interact with:

Metformin: Risk of lactic acidosis, especially in patients with impaired renal function.
Diuretics: Increased risk of dehydration and kidney damage.

Food Interactions

There are no significant food interactions with Diapac IV Injection 350 mg/ml. However, patients should be well-hydrated before and after the procedure to reduce the risk of kidney complications.

Pregnancy Use

Diapac IV Injection 350 mg/ml should be used in pregnancy only if clearly needed. There is limited data on its use during pregnancy, but iodine-containing contrast agents can cross the placenta and may affect fetal thyroid function.

Lactation Use

Diapac IV Injection 350 mg/ml is excreted in breast milk in very small amounts, but it is generally considered safe to use during breastfeeding. However, breastfeeding can be temporarily interrupted for 24 hours after the procedure if there is concern.

Acute Overdose

In cases of overdose, patients may experience severe hypotension, renal failure, or hypersensitivity reactions. Immediate treatment includes hydration, monitoring of renal function, and supportive care.

Contraindication

Diapac IV Injection 350 mg/ml is contraindicated in patients with:

Severe hypersensitivity to iodine or contrast media
Severe renal impairment
Severe congestive heart failure
Hyperthyroidism

Use Direction

Diapac IV Injection 350 mg/ml should be administered only under the guidance of a healthcare provider experienced in diagnostic imaging. Dosage should be individualized based on the patient's weight, the imaging procedure, and renal function.

Storage Conditions

Diapac IV Injection 350 mg/ml should be stored at room temperature (20-25°C) and protected from light. It should not be frozen. Discard any unused portions after opening.

Volume of Distribution

The volume of distribution of Diapac IV Injection 350 mg/ml is approximately 0.26-0.29 L/kg, which corresponds to extracellular fluid volume, as it is distributed primarily in the vascular and interstitial compartments.

Half Life

The plasma half-life of Diapac IV Injection 350 mg/ml is approximately 2 hours in individuals with normal renal function. In patients with renal impairment, the half-life may be significantly prolonged.

Clearance

Diapac IV Injection 350 mg/ml is cleared from the body primarily by renal excretion. In patients with normal renal function, more than 90% is excreted unchanged in the urine within 24 hours. In patients with impaired renal function, clearance is delayed, and hemodialysis may be necessary to enhance elimination.

See in details version Diapac IV Injection 350 mg/ml also Diapac IV Injection 350 mg/ml in bangla