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Contrast media: interactions with other drugs and clinical tests

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Abstract

Many patients with multiple medical problems who are receiving a variety of drugs are investigated with imaging techniques which require intravascular contrast media. The Contrast Media Safety Committee of the European Society of Urogenital Radiology therefore decided to review the literature and to draw up simple guidelines on interactions between contrast media and other drugs. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Contrast media may interact with other drugs, and may interfere with isotope studies and biochemical measurements. Awareness of the patient drug history is important to avoid potential hazards. Simple guidelines are presented.

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References

  1. Jakobsen JÅ, Oyen R, Thomsen HS, Morcos SK, members of contrast media safety committee of the European Society of Urogenital Radiology (ESUR) (2005) Safety of ultrasound contrast agents. Eur Radiol DOI 10.1007/s00330-004-2601-0

  2. Frohlich JM (2001) Systematic survey of interactions between contrast media and other drugs. Special edition by Guerbet Switzerland

  3. Thomsen HS, Morcos SK, ESUR Contrast Media Safety Committee (1999) Contrast media and metformin. Guidelines to distinguish the risk of lactic acidosis in non-insulin dependent diabetics after administration of contrast media. Eur Radiol 9:738–740

    Google Scholar 

  4. Morcos SK (1998) Contrast media-induced nephrotoxicity—questions and answers. Br J Radiol 71:357–365

    Google Scholar 

  5. Morcos SK, Thomsen HS, Webb JAW and ESUR Contrast Media Safety Committee (1999) Contrast media-induced nephrotoxicity: a consensus report. Eur Radiol 9:1602–1613

    Article  Google Scholar 

  6. Thomsen HS, Morcos SK (2003) Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. Br J Radiol 76:513–518

    Google Scholar 

  7. Swanson DP, Chilton HM, Thrall JH (eds) (1990) Pharmaceuticals in medical imaging: radiopaque contrast media, radiopharmaceuticals, enhancement agents for magnetic resonance imaging and ultrasound. Macmillan Publishers, New York, p 42

    Google Scholar 

  8. Choyke PL, Miller DL, Lotze MT, Whireis JM, Ebbitt B, Rosenberg SA (1992) Delayed reactions to contrast media after interleukin-2 immunotherapy. Radiology 183:111–114

    Google Scholar 

  9. Reynolds N, Wallington TB, Burton JL (1993) Hydralazine predisposes to acute cutaneous vasculitis following urography with iopamidol. Br J Dermatol 129:82–85

    Google Scholar 

  10. Laurence DR, Bennett PN (1992) Clinical pharmacology, 7th edn. Churchill Livingstone, Edinburgh, pp 416–423

    Google Scholar 

  11. Lang DM, Alpern MB, Visintainer PF, Smith ST (1991) Increased risk for anaphylactoid reaction from contrast media in patients on beta-adrenergic blockers or with asthma. Ann Intern Med 115:270–276

    Google Scholar 

  12. Lang DM, Alpern MB, Visintainer PF, Smith ST (1993) Elevated risk of anaphylactoid reaction from radiographic contrast media is associated with both beta-blocker exposure and cardiovascular disorders. Arch Intern Med 153:2033–2040. Erratum in: Arch Intern Med 1993; 153:2412

    Google Scholar 

  13. Abi-Aad AS, Figlin RA, Belldegrun A, de Kernion JB (1991) Metastatic renal cell cancer: interleukin-2 toxicity induced by contrast agent injection. J Immunother 10:292–295

    Google Scholar 

  14. Massee DR, Smith DC, Westengard JC, Bull BS (1991) Heparin supplementation of nonionic contrast agents. J Vasc Interv Radiol 2:209–213

    Google Scholar 

  15. Parvez Z, Moncada R, Messmore HL, Fareed J (1982) Ionic and nonionic contrast media interaction with anticoagulant drugs. Acta Radiol Diagn (Stockh) 23:401–404

    Google Scholar 

  16. Dehmer GJ, Gresalfi N, Daly D, Oberhardt B, Tate DA (1995) Impairment of fibrinolysis by streptokinase, urokinase and recombinant tissue-type plasminogen activator in the presence of radiographic contrast agents. J Am Coll Cardiol 25:1069–1075

    Google Scholar 

  17. Pislaru S, Pislaru C, Szilard M, Arnout J, van de Werf F (1998) In vivo effects of contrast media on coronary thrombolysis. J Am Coll Cardiol 32:1102–1108

    Google Scholar 

  18. Higgins CB, Kruber M, Slutsky RA (1983) Interaction between verapamil and contrast media in coronary arteriography: comparison of standard ionic and new nonionic media. Circulation 68:628–635

    Google Scholar 

  19. Morris DL, Wisneski JA, Gertz EW, Wexman M, Axelrod R, Langberg JJ (1985) Potentiation by nifedipine and diltiazem of the hypotensive response after contrast angiography. J Am Coll Cardiol 6:785–791

    Google Scholar 

  20. Morcos SK, Dawson P, Pearson JD et al (1998) The hemodynamic effects of iodinated water soluble radiographic contrast media: a review. Eur J Radiol 29:31–46

    Google Scholar 

  21. Fischer HW, Morris TW (1980) Possible factors in intravascular contrast media toxicity. Invest Radiol 15(Suppl 6):S232–S238

    Google Scholar 

  22. Van der Molen AJ, Thomsen HS, Morcos SK, ESUR Contrast Media Safety Committee (2004) Effect of iodinated contrast media on thyroid function in adults. Eur Radiol 14:902–907

    PubMed  Google Scholar 

  23. Crawford JA, Gumerman LW (1978) Alteration of body distribution of Tc99m-pyrophosphate by radiographic contrast material. Clin Nucl Med 3:305–307

    Google Scholar 

  24. Tatum JL, Burke TS, Hirsch JI, Miller WW, Fratkin MJ (1983) Pitfall to modified in vivo method of technetium-99m red blood cell labeling. Iodinated contrast media. Clin Nucl Med 8:585–587

    Google Scholar 

  25. Kim SH, Lee HK, Han MC (1992) Incompatibility of water-soluble contrast media and intravascular pharmacologic agents. An in vitro study. Invest Radiol 27:45–49

    Google Scholar 

  26. Morcos SK, El Nahas AM, Brown P, Haylor J (1992). Effect of iodinated water soluble contrast media on urinary protein assays. BMJ 305:29

    CAS  Google Scholar 

  27. Prince MR, Erel HE, Lent RW et al (2003) Gadodiamide administration causes spurious hypocalcemia. Radiology 227:639–646

    Google Scholar 

  28. Choyke PL, Knopp MV (2003). Pseudohypocalcemia with MR imaging contrast agents: a cautionary tale. Radiology 227:627–628

    Google Scholar 

  29. Proctor KAS, Rao LV, Roberts WL (2004) Gadolinium magnetic resonance contrast agents produce analytic interference in multiple serum assays. Am J Clin Pathol 121:282–292

    Google Scholar 

  30. Normann PT, Frøysa A, Svaland M (1995) Interference of gadodiamide injection (OMNISCAN®) on the colorimetric determination of serum calcium. Scand J Clin Lab Invest 55:421–426

    Google Scholar 

  31. Junge W, Troge B (1991) Kontrastmittel als Störfaktoren in der laborchemischen Analytik. In: Peters PE, Zetler E (eds) Röntgen Kontrastmittel. Springer Verlag, Berlin Heidelberg New York, pp 76–82

    Google Scholar 

  32. Barrs TJ (2002) Establishing safeguards for the use of imaging related drugs. Am J Health-Syst Pharm 59:1449–1553

    Google Scholar 

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Correspondence to Henrik S. Thomsen.

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Members of the committee: H.S. Thomsen (Chairman, Denmark), S.K. Morcos (Secretary, UK), T. Almén (Sweden), P. Aspelin (Sweden), M.F. Bellin (France), H. Flaten (Amersham Health, Norway), J.Å. Jakobsen (Norway), A. Löwe (Schering, Germany), R. Oyen (Belgium), A. Spinazzi (Bracco, Italy), F. Stacul (Italy), A.J. van der Molen (The Netherlands), J.A.W. Webb (UK).

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Morcos, S.K., Thomsen, H.S., Exley, C.M. et al. Contrast media: interactions with other drugs and clinical tests. Eur Radiol 15, 1463–1468 (2005). https://doi.org/10.1007/s00330-004-2600-1

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  • DOI: https://doi.org/10.1007/s00330-004-2600-1

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