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Indications & Uses
Visican injection is a radiographic contrast agent used for the following purposes. For intra-arterial procedures, in adults and pediatric patients 12 years of age and over, it is used for intra-arterial digital subtraction angiography (270 and 320 mg Iodine/mL), as well as angiocardiography (left ventriculography and selective coronary arteriography), peripheral arteriography, visceral arteriography, and cerebral arteriography (320 mg Iodine/mL). In pediatric patients less than 12 years of age, it is used for angiocardiography, cerebral arteriography, and visceral arteriography (320 mg Iodine/mL). For intravenous procedures, in adults and pediatric patients 12 years of age and over, it is used for computed tomography (CT) imaging of the head and body and excretory urography (270 and 320 mg Iodine/mL), CT imaging peripheral venography (270 mg Iodine/mL), and coronary computed tomography angiography (CCTA) to assist diagnostic evaluation of patients with suspected coronary artery disease (320 mg Iodine/mL). In pediatric patients less than 12 years of age, it is used for CT imaging of the head and body and excretory urography (270 mg Iodine/mL).
Pharmacology
Iodixanol is injected into a blood vessel, and it opacifies the vessels in the path of flow of the contrast agent. This lets the internal structures be seen on x-ray until the agent is significantly diluted and eliminated. In imaging of the body, iodinated contrast agents diffuse from the vascular into the extravascular space. In a normal brain with an intact blood-brain barrier, contrast does not diffuse into the extravascular space. In patients with a disrupted blood-brain barrier, the contrast agent accumulates in the interstitial space in the region of disruption.
Iodixanol is a dimeric, isosmolar, nonionic, water soluble, iodinated x-ray contrast agent for intravascular administration.
Pharmacokinetics
Distribution: In an in vitro human plasma study, iodixanol did not bind to protein. The volume of distribution was 0.26 liter per kg of body weight, which is consistent with distribution to the extracellular space.
Metabolism: Iodixanol metabolites have not been demonstrated.
Excretion: Plasma and urine levels suggest that the body clears iodixanol mainly through the kidneys. In adults, about 97% of the injected dose is excreted unchanged in urine within 24 hours, and less than 2% is excreted in feces within five days after injection.
Pharmacodynamics
As with other iodinated contrast agents, after Visican Injection is given, the degree of enhancement is directly related to the iodine content of the dose. Peak iodine plasma levels occur immediately after a rapid intravascular injection. They then fall quickly, within 5 to 10 minutes, and this is accounted for by dilution in the vascular and extravascular fluid compartments.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adult Dosage: For intra-arterial use, at a concentration of 270/320 mg I/ml, arteriographies are given as 5 to 10 ml per injection, selective cerebral arteriography as 40 to 60 ml per injection, and peripheral aortography as 30 to 60 ml per injection. For angiocardiography, at a concentration of 320 mg I/ml, the left ventricle and aortic root are given 30 to 60 ml per injection, and selective coronary arteriography is given 4 to 8 ml per injection. For intravenous use, at a concentration of 270/320 mg I/ml, urography CT enhancement uses 40 to 80 ml, CT of the body uses 50 to 150 ml, and CT of the head uses 75 to 150 ml.
Paediatric Dosage: For intra-arterial use, at a concentration of 320 mg I/ml, cardioangiography is given as 1 to 2 ml/kg, with a maximum recommended dose of 10 ml/kg; all doses depend on age, weight and pathology. For intravenous use, at a concentration of 270/320 mg I/ml, urography in children under 7 kg and in children over 7 kg is given as 2 to 3 ml/kg up to 50 ml, though up to 150 ml may be given in a few cases. CT enhancement, at a concentration of 270/320 mg I/ml, for CT of the body is given as 2 to 3 ml/kg up to 50 ml, though up to 150 ml may be given in a few cases. For upper gastrointestinal studies in children, at a concentration of 320 mg I/ml, the dosage must be adjusted individually to allow optimal visualization, generally around 5 ml/kg body weight, with doses of 10 to 240 ml having been studied.
Side Effects
After Visican injection, adult patients most often reported (in more than 0.5% of cases) discomfort, warmth, and pain. Cardiovascular reactions included angina. Gastrointestinal reactions included diarrhea, nausea, and vomiting. Nervous system reactions included agitation, anxiety, insomnia, nervousness, dizziness, headache, migraine, unusual skin sensations, sensory disturbance, fainting, and a sensation of spinning. Skin reactions included itchy rash, severe itching, and hives. Special senses could be affected through alteration of smell, taste, and vision. Pediatric patients experienced similar adverse reactions.
Cautions & Contraindications
Warnings & Precautions
Precautions for non-ionic contrast media in general: the risk of serious reactions with Visican is regarded as minor. Even so, iodinated contrast media may provoke anaphylactoid reactions or other signs of hypersensitivity. A course of action should be planned in advance, with the necessary drugs and equipment at hand for immediate treatment if a serious reaction occurs. It is advisable to keep an indwelling cannula or catheter in place for quick intravenous access throughout the whole X-ray procedure. As with other iodinated contrast agents, contrast enhancement with Visican injection may obscure some lesions that were seen on earlier unenhanced CT scans. In patients with normal blood-brain barriers and renal failure, iodinated contrast agents have been linked with blood-brain barrier disruption and build-up of contrast in the brain. Enhancement of the inferior vermis after a contrast agent is given has led to false positive diagnosis. Hydration Patients should be well hydrated before and after any contrast medium, Visican included, to prevent acute renal failure. This matters most for patients with multiple myeloma, diabetes mellitus or renal dysfunction, and for elderly patients. Dehydrating a patient as preparation is dangerous and may contribute to acute renal failure in those with existing renal insufficiency, diabetes or advanced vascular disease. Overnight fluid restriction before excretory urography is generally believed not to give better visualization in normal patients. To avoid contrast induced nephropathy, the following should be considered: Identification of high risk patients. Ensuring adequate hydration. The patient should be hydrated (for example, at least 100 ml per hour of soft drinks or intravenous saline) for up to 24 hours after the contrast medium is given. In warm areas, more fluid should be given. If necessary, keep an i.v. infusion running from before the procedure until the kidneys have cleared the contrast medium. Avoid putting extra strain on the kidneys, such as nephrotoxic drugs, oral cholecystography agents, arterial clamping, renal arterial angioplasty or major surgery, until the contrast medium has been cleared. Postpone any repeat contrast medium examination until renal function returns to pre-examination levels. Monitor renal function (serum creatinine), serum lactic acid and the pH of blood. Look for symptoms of lactic acidosis: vomiting, somnolence, nausea, epigastric pain, anorexia, hyperpnea, lethargy, diarrhoea and thirst.
Contraindications
Iodixanol Injection should not be used intrathecal, meaning it must never be given into the fluid around the spinal cord. In children, prolonged fasting and giving a laxative before a Visican injection are both contraindicated.
Pregnancy & Breastfeeding
Pregnancy: No data are available on the use of Iodixanol during pregnancy, so any risks it may pose cannot be assessed. Breastfeeding: A mother who is breastfeeding may express and discard her breast milk for 10 hours after receiving Iodixanol.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Geriatrics
Take care when choosing the dose for elderly patients.
Pediatric Use
Dixanol has been shown to be safe and effective in children from birth for angiocardiography, cerebral arteriography, visceral arteriography, CT imaging of the head and body, and excretory urography. In children aged 12 years and older, its safety and efficacy have also been established for intra-arterial digital subtraction angiography, peripheral arteriography, CT imaging peripheral venography and CCTA.
Overdose
An overdose of any contrast agent can cause life-threatening effects, mainly on the lungs and the heart and blood vessels. Treatment focuses on supporting all vital functions and starting symptomatic therapy promptly. Dixanol Injection does not bind to plasma or serum protein, so it can be removed by dialysis.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Iodixanol at controlled room temperature, 20°C-25°C. Short excursions to 15°C-30°C are permitted.
Drug Interactions
Common questions about Dixanol 50 ml
What is Dixanol 50 ml Injection?
Dixanol 50 ml Injection is a medicine that contains Iodixanol. It is made by Techno Drugs Ltd., Satipara, Narshingdi. It belongs to the Contrast medium for diagnostic procedures group of medicines.
What is Dixanol used for?
Visican injection is a radiographic contrast agent used for the following purposes. For intra-arterial procedures, in adults and pediatric patients 12 years of age and over, it is used for intra-arterial digital subtraction angiography (270 and 320 mg Iodine/mL), as well as angiocardiography (left ventriculography and selective coronary arteriography), peripheral arteriography, visceral arteriography, and cerebral arteriography (320 mg Iodine/mL).
What are the side effects of Dixanol?
After Visican injection, adult patients most often reported (in more than 0.5% of cases) discomfort, warmth, and pain. Cardiovascular reactions included angina.
Can I take Dixanol during pregnancy or while breastfeeding?
Pregnancy: No data are available on the use of Iodixanol during pregnancy, so any risks it may pose cannot be assessed. Breastfeeding: A mother who is breastfeeding may express and discard her breast milk for 10 hours after receiving Iodixanol. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Dixanol?
An overdose of any contrast agent can cause life-threatening effects, mainly on the lungs and the heart and blood vessels. Treatment focuses on supporting all vital functions and starting symptomatic therapy promptly. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Dixanol?
Store Iodixanol at controlled room temperature, 20°C-25°C. Short excursions to 15°C-30°C are permitted.
Can I take other medicines with Dixanol?
Some medicines can interact with Iodixanol, for example: Metformin, Iodine, Adrenaline. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Dixanol?
Dixanol is a prescription (Rx) medicine. Take it as your doctor advises.