HIGH-OSMOLAR AND LOW-OSMOLAR CONTRAST-MEDIA - AN UPDATE ON FREQUENCY OF ADVERSE DRUG-REACTIONS

During the past 3 years a great number of papers about adverse drug re actions to intravascular injection of high-osmolar and low-osmolar iod inated contrast media (CM) have been published. They include observati onal studies, randomized trials, meta-analyses and committee reports. Thorough analysis of this material substantiates an improvement in saf ety of at least 6-fold using nonionic low-osmolar CM compared with ion ic high-osmolar CM. The point where only a small minority is continuin g to argue effectively that low-osmolar CM are not better than convent ional high-osmolar CM has now been reached. High-osmolar CM are used l ess and less for intravascular purposes, and, in fact, have been total ly replaced by low-osmolar CM in 4 countries.