Ipodate Sodium
Sodium iopodate / Calcium iopodate
Also known as: Solu-Biloptin · Solubiloptine · Bilivist · Oragrafin · Calcium iopodate · Calcium ipodate · Sodium iopodate · NSC-106962
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Medical treatment of hyperthyroidism in patients who cannot tolerate methimazole and whose owners will not permit surgery or radioiodine therapy | 100-200 mg (total dose; empiric) PO once daily | PO | q24h | — | 🌎 NA |
| Medical treatment of hyperthyroidism in patients who cannot tolerate methimazole and whose owners will not permit surgery or radioiodine therapy | 50 mg per cat PO twice daily, if 'good' clinical response not obtained, at 2 week intervals may increase dose to 150 mg/day (100 mg AM, 50 mg PM) and then to 200 mg/day (100 mg twice daily) | PO | q12h | — | 🌎 NA |
| For use before surgery | 15 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- Medical treatment of hyperthyroidism in patients who cannot tolerate methimazole and whose owners will not permit surgery or radioiodine therapy: Cats with severe hyperthyroidism are less likely to respond.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Ipodate sodium is an oral radiopaque organic iodine compound originally utilized in human medicine as a contrast agent for cholecystography. In veterinary medicine, it has been repurposed as an alternative antithyroid agent for cats suffering from hyperthyroidism, particularly those that cannot tolerate first-line medications like methimazole or carbimazole.
While it can be effective in reducing the clinical signs of hyperthyroidism, its use is limited by a few significant factors:
- Transient Efficacy: Cats often become refractory to the medication after a relatively short period.
- Availability: There are no commercial veterinary or human products available; it must be formulated by a compounding pharmacy.
- Severity of Disease: It is generally less effective in cats with severe hyperthyroidism.
Clinical Pearl: Because ipodate does not lower serum T4 levels (and may actually increase them due to decreased clearance), therapeutic monitoring must rely on clinical signs and serum T3 levels.
Mechanism of action
Ipodate acts via a completely different mechanism than thioureylene antithyroid drugs (like methimazole). Its primary effects include:
- 5'-deiodinase inhibition: It potently inhibits the enzyme responsible for the peripheral conversion of thyroxine (T4) → the more biologically active triiodothyronine (T3).
- Receptor Blockade: It may competitively block T3 receptors in target tissues, thereby protecting organs such as the heart from the hypertrophic and thyrotoxic effects of hyperthyroidism.
- TSH Interference: It may block the actions of Thyroid Stimulating Hormone (TSH).
Safety & warnings
Contraindications
- Known hypersensitivity to ipodate or other iodine compounds
- Pregnancy (risk of congenital hypothyroidism in fetuses)
Adverse effects
- GI distress (nausea, vomiting, diarrhea, cramping, inappetence)
- Transient efficacy (patients may become refractory)
- Drug-induced pemphigus (rare)
- Skin rashes, itching, dizziness, and headache (reported in humans)
Precautions
Use with caution in patients who have had previous hypersensitivity reactions to iodine compounds. In humans, multiple doses are contraindicated in patients with hepatic dysfunction due to reports of renal toxicity. Use with caution in patients with hyperuricemia due to the possibility of uric acid nephropathy.
Laboratory Interferences:
- May increase BSP retention times and serum bilirubin levels.
- May cause false-positive urine protein determinations.
- Interferes with thyroid scanning.
Drug interactions
Ipodate may interfere with radioactive iodine uptake and therapy. It is recommended to discontinue ipodate at least 2 weeks (preferably 3-4 weeks or more) prior to I-131 treatment.
Monitoring
- Clinical efficacy (heart rate, body weight, resolution of clinical signs)
- Serum T3 levels (Note: T4 levels typically do not decrease and may remain high; T4 is NOT a reliable indicator of efficacy for this specific drug)
Pharmacokinetics
Absorption
Well absorbed after oral administration.
Distribution
Pertinent pharmacokinetic data for cats is unavailable.
Metabolism
Pertinent pharmacokinetic data for cats is unavailable.
Elimination
Pertinent pharmacokinetic data for cats is unavailable.
Overdose
No specific information located regarding acute toxicity. Cats have reportedly tolerated daily doses up to 400 mg without severe acute adverse effects.
Available products
Formulations
- Compounded capsules
- Compounded oral suspension
Veterinary
- None
Human-labeled
- None (Must be obtained via a compounding pharmacy)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store capsules in tight containers and protect from light.
Client information
What is this medication? Ipodate is used to manage hyperthyroidism (an overactive thyroid gland) in cats, usually when standard medications like methimazole cause unacceptable side effects.
Important points for pet owners:
- Not a Cure: This drug decreases the effects of excessive thyroid hormones but does not cure the underlying condition. Strict compliance with daily dosing is necessary for success.
- Fading Effectiveness: The long-term effectiveness of this drug is questionable. Many cats become "refractory" to it, meaning the drug may stop working after a few months.
- Monitoring is Different: Unlike standard thyroid medications, your veterinarian will monitor your cat's weight, heart rate, and a specific thyroid hormone called T3 (instead of the usual T4).
- Compounding Required: Because this medication is not commercially manufactured, it must be specially made (compounded) by a veterinary pharmacy.
- Side Effects: Watch for signs of stomach upset, such as vomiting, diarrhea, or loss of appetite. Contact your veterinarian if these occur.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.