IODIXANOL - A REVIEW OF ITS PHARMACODYNAMIC AND PHARMACOKINETIC PROPERTIES AND DIAGNOSTIC USE AS AN X-RAY CONTRAST-MEDIUM

Iodixanol is an iso-osmolal nonionic dimeric hydrophilic contrast agen t. It has similar diagnostic efficacy to that of other iodinated contr ast media. Because of its physical properties, iodixanol would be expe cted to produce a lower incidence of adverse events than other nondime ric contrast media. Indeed, pharmacodynamic studies indicate that iodi xanol has fewer cardiovascular effects, causes less renal damage and i s associated with similar or smaller changes to the blood-brain barrie r and neurological function when compared with nondimeric nonionic con trast media. In clinical trials, iodixanol had a similar tolerability profile to other nonionic contrast media but induced fewer adverse eve nts than ioxaglate. Iodixanol appears to have an advantage over other contrast media in that it generally causes less frequent and less inte nse discomfort on injection. However, in common with other newer, and usually nonionic, contrast media, iodixanol is expensive. Studies inve stigating other nonionic contrast media (but not iodixanol) have shown that it is not cost-effective in all patients to replace older, usual ly ionic, contrast media with more costly newer alternatives. Nonethel ess, in selected patients who are considered at increased risk of cont rast medium-associated adverse events, nonionic agents should be used. Iodixanol, with its lower intensity (and possible frequency) of disco mfort, may be a preferred option in these patients.