Amidotrizoate (Diatrizoate)

Generic Name: Amidotrizoate

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.

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.

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Diatrizoate is an iodine-containing X-ray contrast agent. Iodated contrast agents were among the first contrast agents developed. Iodine is known to be particular electron-dense and to effectively scatter or stop X-rays. A good contrast agent requires a high density of electron-dense atoms. Therefore, the more iodine, the more "dense" the x-ray effect. Iodine based contrast media are water soluble and harmless to the body. These contrast agents are sold as clear colorless water solutions, the concentration is usually expressed as mg I/ml. Modern iodinated contrast agents can be used almost anywhere in the body. Most often they are used intravenously, but for various purposes they can also be used intraarterially, intrathecally (the spine) and intraabdominally - just about any body cavity or potential space.

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.

This product may also be given rectally prior to an X-ray or other contrast test if your doctor needs to view your lower intestine. Consult your doctor for more information on your test. SIDE EFFECTS: Nauseavomitingdiarrheastomach cramps, rash, itching, or heartburn may occur.

Usual adult and adolescent dose
Cystourethrography, retrograde
Intravesical instillation, 25 to 300 mL or more, depending on age and bladder capacity, of a solution containing the equivalent of 85 mg or 141 mg of iodine per mL. 

Pyelography, retrograde
Intraureteral instillation, 6 to 10 mL, up to 15 mL, of a solution containing the equivalent of 85 mg or 141 mg of iodine per mL for unilateral pyelograms. Dose may be doubled for bilateral pyelograms.

Diagnostic interference
The following have been selected on the basis of their potential clinical significance (possible effect in parentheses where appropriate)—not necessarily inclusive (» = major clinical significance):

With results of retrograde pyelography

Due to other medications
Dyclonine    (may interfere with visualization when used as a local anesthetic in cystoscopic procedures following pyelography because of possible reaction with the iodine in diatrizoate, which may result in precipitation of iodine )

Manufacturer's package insert or other appropriate literature should be consulted for specific techniques and procedures for the administration of contrast media.

Sensitivity test doses are not usually recommended since severe or fatal reactions to contrast media are not predictable from a patient's history or a sensitivity test. On some occasions severe or fatal reactions have occurred with a test dose or with a full dose in patients who did not react to the test dose.

Cross-sensitivity and/or related problems

Patients sensitive to iodine or other iodinated contrast media may be sensitive to diatrizoates also. 

Carcinogenicity/Mutagenicity

Long-term animal studies to evaluate carcinogenic or mutagenic potential of diatrizoates have not been performed. 

Pregnancy/Reproduction

Pregnancy—
Diatrizoates cross the placenta and are evenly distributed in fetal tissue. Other organically bound iodine-containing preparations administered near term by intra-amniotic injection have caused hypothyroidism in some newborns. 

Also, elective contrast radiography of the abdomen is usually not recommended during pregnancy because of the risks to the fetus from radiation exposure.

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