Adult: As 300 mg iodine/mL (61%): Femoral or subclavian: 5-40 mL. Aorta for a distal runoff: 25-50 mL. Max cumulative dose: 250 mL. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intra-arterial Selective visceral arteriography or aortography
Adult: As 370 mg iodine/mL (76%): Renal arteries: May give doses of up to 10 mL. Larger vessels (e.g. aorta or coeliac artery): May give doses of up to 50 mL. Max cumulative dose: 225 mL. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intra-arterial Cerebral arteriography
Adult: As 300 mg iodine/mL (61%): 8-12 mL administered via carotid puncture or transfemoral catherisation. Max cumulative dose: 90 mL. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Adult: As 370 mg iodine/mL (76%): Selective coronary artery inj: 2-10 mL. Ventriculography or nonselective opacification of multiple coronary arteries after aortic root inj: 25-50 mL. Max cumulative dose: 200 mL. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intrathecal Myelography
Adult: Lumbar or thoracic myelogram: As 200 mg iodine/mL: 10-15 mL. Cervical myelogram: As 200 mg iodine/mL (41%): 10 mL via lateral cervical inj or 10-15 mL via lumbar inj. As 300 mg iodine/mL (61%): 10 mL via lumbar inj. Total columnar myelography: As 300 mg iodine/mL: 10 mL.
Intrathecal Computed tomographic cisternography
Adult: As 200 mg iodine/mL (41%): 4-6 mL via lumbar inj. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intravenous Excretory urography
Adult: As 250 mg iodine/mL (51%): 50-100 mL. As 300 mg iodine/mL (61%): 50 mL. As 370 mg iodine/mL (76%): 40 mL. Doses are administered via rapid IV inj. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines). Child: As 250 mg iodine/mL (51%): 1.2-3.6 mL/kg (Max: 120 mL). As 300 mg iodine/mL (61%): 1-3 mL/kg (Max: 100 mL). Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intravenous Computed tomography imaging
Adult: Head and body: As 250 mg iodine/mL (51%): 130-240 mL (Max: 240 mL). As 300 mg iodine/mL (61%): 100-200 mL (Max: 200 mL). Doses are administered via rapid IV inj. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines). Child: Head and body: As 250 mg iodine/mL (51%): 1.2-3.6 mL/kg (Max: 120 mL). As 300 mg iodine/mL (61%): 1-3 mL/kg (Max: 100 mL). Doses are administered via rapid IV inj. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
Intravenous Peripheral venography
Adult: As 200 mg iodine/mL (41%): 25-150 mL per lower extremity. Max total dose: 350 mL. Dosage recommendations may vary among countries or individual products (refer to specific product guidelines).
What are the brands available for Iopamidol in Malaysia?
Pamidol
Contraindications
Intrathecal: Myelography must not be performed in the presence of significant local or systemic infection where bacteraemia is possible; immediate repeat myelography in case of technical failure. Concurrent intrathecal administration of corticosteroids.
Special Precautions
Patient with history of bronchial asthma, allergy (including food allergy), family history of allergy or prior allergy or hypersensitivity to contrast mediums; known or suspected phaeochromocytoma; CV disease (e.g. CHF), diabetes mellitus, hyperthyroidism or autonomously functioning thyroid nodule/s, hypercalcaemia, myasthenia gravis, sickle cell disease, cerebral vascular disease, pulmonary hypertension; seizure or history of seizure; CNS disorders, altered blood-brain barrier permeability, increased intracranial pressure, suspicion of intracranial tumour, abscess or haematoma/haemorrhage, multiple sclerosis; chronic alcoholism. Avoid extravasation. Avoid angiocardiography in patients with homocystinuria (IV). Children and elderly. Moderate to severe renal impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Contrast-induced hypersensitivity reactions, acute kidney injury (e.g. renal failure), extravasation, seizures, thyroid storm, hypertensive crisis, encephalopathy, worsening of myasthenia gravis; vasospasm, subsequent cerebral ischaemic phenomena (intra-arterial inj); cerebral haemorrhage, coma, paralysis, arachnoiditis, rhabdomyolysis, hyperthermia, brain oedema (intrathecal). Cardiac disorders: Cardiac dysrhythmias (e.g. extrasystoles, atrial fibrillation, ventricular tachycardia, ventricular fibrillation), chest pain. Gastrointestinal disorders: Nausea, taste alteration, vomiting, diarrhoea, abdominal pain, dry mouth. General disorders and administration site conditions: Feeling hot or cold, pyrexia, inj site pain. Investigations: Increased blood creatinine. Musculoskeletal and connective tissue disorders: Back pain. Nervous system disorders: Headache, dizziness. Renal and urinary disorders: Acute renal failure. Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus, erythema, increased sweating. Vascular disorders: Hypotension, hypertension, flushing. Potentially Fatal: Serious hypersensitivity reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms), thromboembolism causing MI and stroke, severe CV reactions, serious neurological reactions.
Patient Counseling Information
Ensure adequate hydration during treatment.
Monitoring Parameters
Correct fluid or electrolyte imbalances before and after administration of contrast media. Perform ECG during coronary arteriography and ventriculography procedures. Monitor renal function (e.g. urinary output); infusion site reaction (e.g. pain, oedema, extravasation) during IV administration; seizure activity. Assess for signs and symptoms of hypersensitivity during and for at least 30-60 minutes after the procedure, severe skin reactions, CNS irritation.
Overdosage
Symptoms: Intrathecal: Ascending hyperreflexia or tonic-clonic spasms, generalised seizures. In severe cases of central involvement, hyperthermia, stupor, and respiratory depression may occur.
Management: Supportive and symptomatic treatment. May perform haemodialysis to remove iopamidol from the body.
Drug Interactions
May precipitate lactic acidosis with biguanides (e.g. metformin). May increase the risk of neurotoxicity and aseptic meningitis when administered concomitantly with corticosteroids. Increased risk of more severe anaphylactoid reactions with β-blockers. May strongly potentiate neurological effects with vasopressors. Increased risk of renal toxicity in patients with hepatic dysfunction who have recently received oral cholecystographic contrast agents. Concomitant administration of interleukin-2 may result in atypical adverse reactions (e.g. erythema, fever, flu symptoms).
Lab Interference
May decrease iodine-binding capacity of thyroid tissue for up to 2 weeks after administration of contrast media; diagnostic tests using iodine-containing isotopes may be affected. May interfere with laboratory tests for bilirubin, proteins, or inorganic substances (e.g. iron, calcium, copper, phosphate).
Action
Description: Mechanism of Action: Iopamidol is a non-ionic iodinated radiographic contrast medium. It allows radiographic visualisation by opacifying blood vessels and anatomical structures, including tissues and organs, along the path of contrast media flow. Pharmacokinetics: Distribution: Distributed into the vascular and extracellular fluid compartments (IV). Crosses the placenta. Excretion: Via urine (80-90% as unchanged drug). Elimination half-life: Approx 2 hours.
Chemical Structure
Iopamidol Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 65492, Iopamidol. https://pubchem.ncbi.nlm.nih.gov/compound/Iopamidol. Accessed Oct. 28, 2025.
Storage
Store between 20-25°C. Protect from light. Discard any unused inj within 10 hours of initial puncture of the imaging bulk package.
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