An iopromide tail vein injection can cause contrast-induced nephropathy [1]. The overall picture quality and diagnostic quality in randomized controlled studies were shown to be on par with other low-penetration contrast agents such as iodixanol, or the isotonic contrast agent iohexol, iopromide, iopamidol, iomepropanol, and ioxagate. imaging using radiography. Extensive postmarketing surveillance studies have verified that iodobitol is an effective contrast agent in the great majority of patients and generates good or exceptional opacification. Iodopidol shares tolerance traits with other low- and isotonic contrast agents, and it is generally well tolerated. Iodobitol is therefore a useful intravascular medication for improving contrast in diagnostic imaging [2].

Absorption, Distribution and Excretion
Following intravascular injection, iopromide reaches peak plasma concentration immediately and then rapidly distributes into the extracellular fluid. It has a low tendency to bind to serum or plasma proteins. Iodinated contrast agents can cross the damaged blood-brain barrier. In healthy adult subjects, 97% of the administered dose is excreted unchanged in the urine. Only 2% is excreted in the feces. Urinary and fecal recovery rates are similar in middle-aged and elderly patients. This finding suggests that bile and/or gastrointestinal excretion is not significant for iopromide compared to the renal route. In the slower terminal phase, only 3% of the dose is cleared; 97% is cleared in the early phase, with the majority occurring in the major clearance phase. The renal clearance-to-creatinine clearance ratio of iopromide is 0.82, suggesting that iopromide is primarily excreted via glomerular filtration. Additional tubular reabsorption may also occur. The total volume of distribution at steady state is approximately 16 L, suggesting distribution in the extracellular space. The mean total clearance and renal clearance were 107 mL/min and 104 mL/min, respectively. Metabolism/Metabolites: Iopromide does not undergo significant metabolism, deiodination, or biotransformation. Biological Half-Life: In healthy adult subjects, the plasma ioopromide concentration-time curves after intravenous injection showed the following: initial distribution phase, half-life of 0.24 hours; major elimination phase, half-life of 2 hours; and terminal elimination phase, half-life of 6.2 hours.

Effects During Pregnancy and Lactation
◉ Overview of Use During Lactation
Very little iodinated contrast agents are excreted into breast milk after intravenous administration, and oral absorption is also poor. Therefore, they are unlikely to enter the infant's bloodstream and will not cause any adverse effects on breastfed infants. Guidelines developed by multiple professional organizations indicate that breastfeeding mothers do not need to interrupt breastfeeding after receiving iodinated contrast agents. However, since there is currently no published experience regarding the use of iopromide during lactation, other contrast agents may be preferred, especially when breastfeeding newborns or premature infants. ◉ Effects on Breastfed Infants
No published information found as of the revision date. ◉ Effects on Lactation and Breast Milk
No published information found as of the revision date.

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Protein Binding
The plasma protein binding rate of iopromide is 1%.

[1]. Jiang W, et al. Breviscapine attenuatted contrast medium-induced nephropathy via PKC/Akt/MAPK signalling in diabetic mice. Am J Transl Res. 2016 Feb 15;8(2):329-41.
[2]. McCormack PL, et al. Iobitridol: a review of its use as a contrast medium in diagnostic imaging. Clin Drug Investig. 2013 Feb;33(2):155-66

Iopromide is a dicarboxylic acid diamide composed of N-methylisophthalamide with three iodine substituents at positions 2, 4, and 6, a methoxyacetyl substituent at position 5, and two 2,3-dihydroxypropyl groups attached to the nitrogen atom of the amide. It is a water-soluble X-ray contrast agent used for intravascular administration. Iopromide has various applications, including as a radiopaque medium, a nephrotoxic substance, an exogenous substance, and an environmental pollutant. It is an organic iodine compound and a dicarboxylic acid diamide. Its structure is similar to that of isophthalamide and glycerol. Iopromide is a hypotonic, nonionic X-ray contrast agent used for intravascular administration. It exerts its imaging effect by visualizing blood vessels in the contrast agent's flow path, thereby enabling radiographic imaging of internal structures before significant blood dilution occurs. Although ioopromide can cause a variety of serious adverse reactions, including cardiac events, thromboembolism, hypersensitivity reactions, and even death in cases of accidental intrathecal injection, its safety profile remains good; in a two-year study, only 0.7% of patients experienced adverse events. Although its mechanism is not fully understood, women and outpatients tend to have a higher incidence of adverse events compared to other populations. Iopromide was approved by the US FDA in 1995 and by Health Canada in 1994, under the brand name ULTRAVIST. It is used for radiological diagnostics, including but not limited to intra-arterial digital subtraction angiography (IA-DSA), cerebral angiography and peripheral angiography, peripheral venography, excretory urography, brain computed tomography (CT), coronary angiography, left ventricular angiography, visceral angiography, and anteroposterior angiography. Iopromide is a contrast agent. The mechanism of action of iopromide is as an X-ray contrast agent. Iopromide is a contrast agent.

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Drug Indications
Iopromide (brand name IOVIST) has been approved by the FDA for use as an intra-arterial or intravenous X-ray contrast agent. For intra-arterial administration, iopromide is indicated for cerebral angiography, peripheral angiography, coronary angiography, left ventricle angiography, visceral angiography, and aortic angiography in adults, and for radiographic evaluation of cardiac chambers and related arteries in children aged 2 years and older. For intravenous administration, iopromide is indicated for excretory urography in adults and children aged 2 years and older; enhanced CT scans of the head and trunk (intrathoracic, intraperitoneal, and retroperitoneal regions) in adults and children aged 2 years and older for evaluation of neoplastic and non-neoplastic lesions; and enhanced mammography in adults to visualize known or suspected breast lesions following mammography and/or ultrasound. Iopromide has also been approved by Health Canada for use as an intravascular contrast agent, but its indications vary by dosage. Iopromide at a concentration of 300 mg I/mL is suitable for computed tomography (CT), excretory urography, pediatric excretory urography, renal arteriography, peripheral arteriography (bifemoral pelvis/legs), cerebral arteriography, limb venography, and arthrography.
FDA Label

Mechanism of Action

Iopromide is a non-ionic, water-soluble iodinated contrast agent available in two stable, ready-to-use solutions at different concentrations (300 mg I/mL and 370 mg I/mL). After intravenous injection, ioopromide creates radiocontrast in the blood vessels and extracellular spaces through which the contrast agent flows, allowing for diagnostic assessment of the extremities and internal organs before significant dilution of the contrast agent.
Pharmacodynamics

Following intravenous injection, renal parenchyma visualization begins within 1 minute. Contrast agent excretion begins within 1 to 3 minutes, with optimal visualization of the renal calyces and collecting system occurring within 5 to 15 minutes.
In kidney disease, especially when excretion capacity is altered, the excretion rate varies unpredictably, and contrast enhancement may be delayed for several hours after injection. The degree of contrast agent enhancement is related to the iodine concentration in the target tissue.

C18H24I3N3O8

791.11

790.869

73334-07-3

Iopromide-d3

3736

White to off-white solid powder

2.2±0.1 g/cm3

840.9±65.0 °C at 760 mmHg

broad (160ºC transition)

462.4±34.3 °C

0.0±3.3 mmHg at 25°C

1.710

-2.95

6

8

11

32

647

0

IC1=C(C(N([H])C([H])([H])C([H])(C([H])([H])O[H])O[H])=O)C(=C(C(=C1C(N(C([H])([H])[H])C([H])([H])C([H])(C([H])([H])O[H])O[H])=O)I)N([H])C(C([H])([H])OC([H])([H])[H])=O)I

DGAIEPBNLOQYER-IUCAKERBSA-N

InChI=1S/C18H24I3N3O8/c1-24(4-9(28)6-26)18(31)12-13(19)11(17(30)22-3-8(27)5-25)14(20)16(15(12)21)23-10(29)7-32-2/h8-9,25-28H,3-7H2,1-2H3,(H,22,30)(H,23,29)/t8-,9-/m0/s1

1,3-Benzenedicarboxamide, N,N'-bis(2,3-dihydroxypropyl)-2,4,6-triiodo-5-((methoxyacetyl)amino)-N-methyl-

Ultravist SHL 414C Iopromide SHL 414C Ultravist UNII-712BAC33MZ ZK 35760.

2934.99.9001

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)

DMSO : ~100 mg/mL (~126.40 mM)
H2O : ~100 mg/mL (~126.40 mM)

Solubility in Formulation 1: ≥ 2.5 mg/mL (3.16 mM) (saturation unknown) in 10% DMSO + 40% PEG300 + 5% Tween80 + 45% Saline (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 400 μL PEG300 and mix evenly; then add 50 μL Tween-80 to the above solution and mix evenly; then add 450 μL normal saline to adjust the volume to 1 mL.
Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH₂ O to obtain a clear solution.

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Solubility in Formulation 2: ≥ 2.5 mg/mL (3.16 mM) (saturation unknown) in 10% DMSO + 90% (20% SBE-β-CD in Saline) (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 900 μL of 20% SBE-β-CD physiological saline solution and mix evenly.
Preparation of 20% SBE-β-CD in Saline (4°C，1 week): Dissolve 2 g SBE-β-CD in 10 mL saline to obtain a clear solution.

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Solubility in Formulation 3: ≥ 2.5 mg/mL (3.16 mM) (saturation unknown) in 10% DMSO + 90% Corn Oil (add these co-solvents sequentially from left to right, and one by one), clear solution.
For example, if 1 mL of working solution is to be prepared, you can add 100 μL of 25.0 mg/mL clear DMSO stock solution to 900 μL of corn oil and mix evenly.

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Solubility in Formulation 4: 100 mg/mL (126.40 mM) in PBS (add these co-solvents sequentially from left to right, and one by one), clear solution; with ultrasonication.

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 (Please use freshly prepared in vivo formulations for optimal results.)