Ioxaglic acid

Source: Wikipedia, the free encyclopedia.
Ioxaglic acid
intraarticular, by mouth
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Protein binding14%
MetabolismNone
Elimination half-life92 min
ExcretionUnchanged via kidneys
Identifiers
  • 3-[(2-hydroxyethyl)carbamoyl]-2,4,6-triiodo-5-(2-{[2,4,6-triiodo-3-(methylcarbamoyl)-5-(N-methylacetamido)phenyl]formamido}acetamido)benzoic acid
JSmol)
  • CC(=O)N(C)C1=C(C(=C(C(=C1I)C(=O)NCC(=O)NC2=C(C(=C(C(=C2I)C(=O)O)I)C(=O)NCCO)I)I)C(=O)NC)I
  • InChI=1S/C24H21I6N5O8/c1-7(37)35(3)20-17(29)10(21(39)31-2)13(25)11(18(20)30)23(41)33-6-8(38)34-19-15(27)9(22(40)32-4-5-36)14(26)12(16(19)28)24(42)43/h36H,4-6H2,1-3H3,(H,31,39)(H,32,40)(H,33,41)(H,34,38)(H,42,43)
  • Key:TYYBFXNZMFNZJT-UHFFFAOYSA-N

Ioxaglic acid (trade name Hexabrix) is pharmaceutical drug used as an

osmolality (relatively few molecules per volume), typically resulting in fewer side effects than high-osmolality media.[1] It is manufactured by Guerbet, but marketing in the US has been discontinued.[2] As of 2021, it may still be available in some European countries.[3]

It is applied in form of its salts, ioxaglate meglumine and ioxaglate sodium.[2]

Medical uses

Uses include

fallopian tubes), imaging of the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP; imaging of the biliary and pancreatic ducts).[4]

Contraindications

Ioxaglic acid is contraindicated in people with

pelvic region, or for arthrography if the joint is infected.[2][4]

Adverse effects

Adverse effects include reactions at the injection site, such as a hot or painful feeling as well as general reactions such as nausea and vomiting. All of these are usually mild and transient. Allergy-like effects such as itching, sneezing, coughing and yawning can be the first sign of severe adverse reactions, especially a shock.[4]

Accidental

cerebral bleed.[2]

Interactions

Iodine-131, a radioactive isotope used for thyroid imaging (scintigraphy) and therapy of thyroid cancers, can be less effective when used within two to six weeks after application of ioxaglic acid because of residual iodine in the body.[4]

Pharmacology

Chemistry and mechanism of action

Further information: Iodinated contrast
Contrast CT of a patient with brain metastases from breast cancer, before (left) and after (right) injection of an iodine-containing contrast agent

Ioxaglic acid is an iodine-containing, water-soluble radiocontrast agent. The iodine atoms readily absorb

mosm/kg water at 37 °C (99 °F), meaning that the solution has a relatively low concentration of molecules; this is usually associated with fewer adverse effects than high-osmolality contrast agents.[2][4]

Pharmacokinetics

After injection into a vein, 14% of the circulating ioxaglic acid is bound to blood

metabolized (unchanged) form via the kidneys with a half-life of 92 minutes (range 61 to 140 minutes).[2] In people with kidney failure, it is eliminated via the bile duct, saliva or sweat.[4]

References

  1. S2CID 39778683
    .
  2. ^ a b c d e f Hexabrix FDA Professional Drug Information. Accessed 2021-03-26.
  3. ^ "Ioxaglic acid: List of nationally authorised medicinal products" (PDF). European Medicines Agency. 31 October 2018.
  4. ^ a b c d e f Haberfeld H, ed. (2020). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. Hexabrix 320 mg Jod/ml-Ampullen.
  5. PMID 8850363
    .
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