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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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
Frohlich JM (2001) Systematic survey of interactions between contrast media and other drugs. Special edition by Guerbet Switzerland
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
Morcos SK (1998) Contrast media-induced nephrotoxicity—questions and answers. Br J Radiol 71:357–365
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
Thomsen HS, Morcos SK (2003) Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. Br J Radiol 76:513–518
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
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
Reynolds N, Wallington TB, Burton JL (1993) Hydralazine predisposes to acute cutaneous vasculitis following urography with iopamidol. Br J Dermatol 129:82–85
Laurence DR, Bennett PN (1992) Clinical pharmacology, 7th edn. Churchill Livingstone, Edinburgh, pp 416–423
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
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
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
Massee DR, Smith DC, Westengard JC, Bull BS (1991) Heparin supplementation of nonionic contrast agents. J Vasc Interv Radiol 2:209–213
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
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
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
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
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
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
Fischer HW, Morris TW (1980) Possible factors in intravascular contrast media toxicity. Invest Radiol 15(Suppl 6):S232–S238
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
Crawford JA, Gumerman LW (1978) Alteration of body distribution of Tc99m-pyrophosphate by radiographic contrast material. Clin Nucl Med 3:305–307
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
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
Morcos SK, El Nahas AM, Brown P, Haylor J (1992). Effect of iodinated water soluble contrast media on urinary protein assays. BMJ 305:29
Prince MR, Erel HE, Lent RW et al (2003) Gadodiamide administration causes spurious hypocalcemia. Radiology 227:639–646
Choyke PL, Knopp MV (2003). Pseudohypocalcemia with MR imaging contrast agents: a cautionary tale. Radiology 227:627–628
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
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
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
Barrs TJ (2002) Establishing safeguards for the use of imaging related drugs. Am J Health-Syst Pharm 59:1449–1553
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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