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| Clinical data | |
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| Trade names | Xenetix |
| AHFS/Drugs.com | UK Drug Information |
| Routes of administration | Intravenous,joint injection,instillation into body cavities |
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| Pharmacokinetic data | |
| Protein binding | ~2% |
| Metabolism | none |
| Eliminationhalf-life | 1.8 hours |
| Excretion | unchanged via kidneys |
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| Chemical and physical data | |
| Formula | C20H28I3N3O9 |
| Molar mass | 835.169 g·mol−1 |
| 3D model (JSmol) | |
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Iobitridol (trade nameXenetix) is a pharmaceutical drug used as aniodine-basedradiocontrast agent inX-ray imaging.[1] It is injected into blood vessels, joints, or body cavities such as theuterus, and filtered out by thekidneys.[2] Its most common adverse effect isnausea. Severe allergic reactions are rare.[1][2]
The drug received its first marketing approval in 1994 in France[3] and is approved for use in many European countries including the UK,[4] but not in the US.[1] It is manufactured byGuerbet.[3]
Iobitridol is used forintravenous urography (imaging of theurinary system via a vein),angiography (imaging of blood vessels),angiocardiography (heart andcoronary arteries),arthrography (joints),hysterosalpingography (uterus andfallopian tubes), and imaging of thecranium and the whole body.[2] It is approved for use in adults and children.[5]
The drug is contraindicated in people with manifesthyperthyreosis because of itsiodine content. It must not be used to image the uterus or fallopian tubes in pregnant women.[2][6]
Iobitridol is generally well tolerated.[5] The only side effect observed in more than 1% of patients isnausea. Rare side effects (in fewer than 1 per 10.000 people) includeanaphylaxis (severe allergic reactions),circulatory collapse,kidney failure,thyroid-related effects, and skin reactions such asStevens–Johnson syndrome. Rare side effects in brain imaging includeconvulsions, transient sight disorders, memory loss, andcoma.[2][6]
Overdosing is unlikely. It is managed byrehydration therapy and monitoring of the kidney function for at least three days. If necessary, iobitridol can be removed from the body byhaemodialysis.[2][6]
Drug interactions are the same as with other iodine-containing contrast agents: patients takingdiuretics are at a higher risk of developing kidney failure under iobitridol unless they receive a water andelectrolyte infusion before imaging.[2] As thediabetes drugmetformin is eliminated via the kidneys, it is recommended that people with severe kidney impairment should pause metformin during and after they are given iobitridol.[7]
Certainantihypertensive (blood pressure lowering) drugs such asbeta-blockers,ACE inhibitors, andsartans can prevent the heart from compensating for low blood pressure, with an increased risk of circulatory collapse.Iodine-131, a radioactiveisotope used for thyroid imaging (scintigraphy) and therapy ofthyroid cancers, can be less effective when used within several weeks after the application of iobitridol because of residual iodine in the body.[2]
Interleukin 2 cancer therapy has been thought to result in more severe side effects than iobitridol,[2] but a 2009 literature search has found no such risk.[8]
Iobitridol is an iodine-containingradiocontrast agent.[2][5] The iodine atoms readily absorbX-rays, resulting in better contrast inradiography images.[9] The quality of images made with this drug is equally good as with other low– or medium–osmolarity iodinatedcontrast agents such asiopamidol oriohexol.[5]
Afterintravenous infusion, iobitridol is distributed in thecirculatory system and theinterstitium. The substance is only marginally bound to bloodplasma proteins (to about 2%) andmembrane proteins because thehydrophilic side chains of the molecule efficiently mask the central iodinatedbenzene ring. It is notmetabolized but eliminated in the unchanged form via the kidneys byglomerular filtration without active secretion or reabsorption. Theelimination half-life is 1.8 hours.[2][5]
In people with kidney failure, the substance is instead eliminated via thebile duct.[2]
Of the molecular mass, 45.6% is contributed by the three iodine atoms. Iobitridol isnonionic but water-soluble,[1] having someOH groups in its side chains designed to mask the centralhydrophobic benzene ring.[5]
The solution has a low osmolarity of 695 (Xenetix 300) or 915 mOsm/kg H2O (Xenetix 350), which means it causes fewer allergic and allergy-like reactions, as well as lessextravasation (leakage of blood vessels) than contrast agents with higher osmolarities.[2][5][10]
