Lopitrast 370mg/50ml Injection

✔️ Lopitrast Injection is used as a radiographic contrast medium for various diagnostic imaging procedures including:

Neuroradiology

• Lumbar myelography
• Thoraco-cervical myelography

Angiography

• Cerebral angiography
• Selective coronary angiography
• Left ventriculography
• Aortography
• Angiocardiography
• Selective visceral arteriography
• Peripheral arteriography
• Digital subtraction angiography
• Venography
• Urography

Other Diagnostic Procedures

• Contrast enhancement in CT scanning
• Arthrography
• Fistulography

✔️ Dosage & Administration of Lopitrast

Adult Dosage

Neuroradiology

• Lumbar 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

Pediatric Dosage

• Usual dose: 1–2.5 ml/kg

Other Diagnostic Procedures

CT Scan Contrast Enhancement

• Iopamidol 370: 0.5–2.0 ml/kg

Angiography

• Cerebral angiography: 6–13 ml
• Selective coronary arteriography: 4–8 ml/artery
• Peripheral arteriography: 20–50 ml
• Venography: 24–60 ml
• Angiocardiography: 30–80 ml
• Left ventriculography: 30–80 ml
• Percutaneous transfemoral or renal arteriography: 30 ml
• Selective renal arteriography: 5–10 ml
• Hepatic angiography: 70 ml
• Coeliac angiography: 40–70 ml
• Superior mesenteric angiography: 25–50 ml
• Inferior mesenteric angiography: 5–30 ml

Digital Subtraction Angiography

• 30–50 ml IV at 10–20 ml/sec
• Cardiac imaging:
  • Left ventricle: 25 ml
  • Coronary arteries: 2–5 ml
  • Intra-arterial injection: 15 ml/sec

✔️ Side Effects

• Nausea and vomiting
• Headache
• Fever and sweating
• Dizziness
• Skin rash or erythema
• Dyspnea
• Hypotension
• Tachycardia
• Severe allergic or anaphylactic reactions
• Ventricular arrhythmias during intracardiac procedures
• Hyperthyroidism recurrence in patients previously treated for Graves’ disease

✔️ Angiography

The injection may be administered via catheterization or direct vascular puncture, depending on the procedure being performed.

✔️ Neuroradiology

For lumbar myelography, a slow subarachnoid injection is administered through a lumbar puncture needle at the L3-L4 or L4-L5 interspace. Imaging should be performed immediately after injection for optimal contrast visualization.

For thoraco-cervical myelography, the patient should be positioned laterally and tilted head-down by 10–20 degrees under fluoroscopic guidance to control movement of the contrast column.

✔️ Urography

Lopitrast is administered intravenously and rapidly excreted through the kidneys. High-dose urography may be required in severe renal impairment.

✔️ CT Scanning

Contrast enhancement can be achieved within 1–3 minutes following IV administration. It may be administered as a bolus injection, drip infusion, or a combination of both.

✔️ Pregnancy & Lactation

Use during pregnancy only if necessary and when the potential benefit outweighs the possible risk. Animal studies have not demonstrated teratogenic effects.

✔️ Precautions & Warnings

• Use only when radiographic contrast examination is clearly indicated.
• Resuscitation facilities and emergency medications should be readily available.
• Ensure adequate hydration before and after administration.
• Use cautiously in patients with cardiovascular, renal, hepatic, or thyroid disorders.
• Do not draw the solution into a syringe until immediately before use.
• The opened bottle must be used immediately, and any remaining solution must be discarded.

✔️ Interaction

• Metformin and other biguanides: May increase the risk of renal dysfunction when used with iodinated contrast media. These drugs should be stopped 48 hours before and after the imaging procedure.
• Thyroid function tests: Iopamidol may interfere with thyroid uptake studies for up to two weeks after administration.

✔️ Lopitrast should generally be avoided in patients with:

• Waldenström’s macroglobulinemia
• Multiple myeloma
• Severe liver disease
• Severe renal impairment
• Known hypersensitivity to iodinated contrast agents

✔️ Storage:

• Store below 30°C
• Protect from light
• Do not use if crystallization occurs or if the container is damaged
• Use immediately after opening and discard any unused portion
• Keep out of the reach of children