碘海醇
Iohexol
5-[acetyl(2,3-dihydroxypropyl)amino]-1-N,3-N-bis(2,3-dihydroxypropyl)-2,4,6-triiodobenzene-1,3-dicarboxamide
別名: Omnipaque · WIN-39424 · iohexolum · ioheksolis
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Estimate GFR (2-4 sample method) | 129-658 mg/kg | IV | Single dose | — | 🌎 NA |
| Estimate GFR (single sample method) | 90 mg iodine content/kg in non-azotemic animals and 45 mg iodine content/kg in azotemic animals | IV | Single dose | — | 🌎 NA |
| Contrast agent for suspected GI perforation | 700-875 mg Iodine/kg, 10 mL/kg | PO | Single dose | — | 🌎 NA |
- Estimate GFR (2-4 sample method): Given over a minute. Lower doses may result in plasma concentrations too low for accurate analysis.
- Estimate GFR (single sample method): Samples drawn at 120 min to assess validity of single-sample method.
- Contrast agent for suspected GI perforation: Best administered via orogastric tube. Radiographs obtained immediately, then at 15, 30, and 60 minutes.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Estimate GFR (single sample method) | 90 mg iodine content/kg in non-azotemic animals and 45 mg iodine content/kg in azotemic animals | IV | Single dose | — | 🌎 NA |
| Contrast agent for suspected GI perforation | 1:3 dilution of iohexol 240 at 10 mL/kg of body weight | PO | Single dose | — | 🌎 NA |
- Estimate GFR (single sample method): Samples drawn at 120 min to assess validity of single-sample method.
- Contrast agent for suspected GI perforation: Best administered via nasogastric/nasoesophageal tube.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Contrast agent (GI abnormalities, transit time) | estimated crop volume of 25-30 mL/kg. Iohexol may be diluted 1:1 with water | PO | Single dose | — | 🌎 NA |
- Contrast agent (GI abnormalities, transit time): Administered directly into the crop by gavage. Retrograde administration directly into the cloaca may help evaluate cloacal abnormalities. Preferred over barium if perforation is suspected.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
碘海醇 (Iohexol) 是一種非離子型、低滲透壓顯影劑 (LOCM)，在獸醫學中廣泛用於放射影像學檢查，並作為評估腎絲球濾過率 (GFR) 的精確標記物。
- 影像學檢查：為脊髓攝影、排泄性尿路攝影、血管攝影及胃腸道檢查提供優異的放射不透明度。
- 安全性：與早期的傳統高滲透壓離子型顯影劑（如泛影酸鹽）相比，碘海醇的滲透壓顯著較低。這使得血流動力學的不良反應減少，內皮細胞與紅血球損傷降低，並減輕注射時的疼痛或灼熱感。
- 腎功能測試：由於它能被腎臟自由濾過，且不被分泌或再吸收，其清除率與菊糖 (inulin) 極為相似。它在血漿和尿液中高度穩定，當標準指標（BUN、肌酸酐）不夠敏感時，是檢測早期腎臟疾病的理想、實用且具成本效益的標記物。
作用機制
- Radiographic Contrast: Iohexol contains organic iodine atoms that absorb X-rays via the photoelectric effect → increases the radiopacity of the fluid or structure it fills → allows clear delineation of adjacent tissues on radiographs or CT scans.
- GFR Marker: Iohexol has negligible protein binding (<1%) and is freely filtered by the glomerulus → it is neither secreted nor reabsorbed by the renal tubules → nearly 100% is excreted unchanged in the urine within 24 hours. By measuring the rate of plasma disappearance over time, clinicians can accurately calculate the glomerular filtration rate (GFR).
安全性與警告
禁忌症
- Prior hypersensitivity reaction to iohexol or iodine-containing products
不良反應
- Hypersensitivity reactions (rare)
- Nephrotoxicity (slight risk)
- Pain or heat sensation at injection site (less common than with ionic agents)
注意事項
Hypersensitivity: Always monitor for signs of anaphylaxis or allergic reactions, even though they are rare in veterinary patients.
- Nephrotoxicity: While the risk is low, use with caution in patients with pre-existing severe renal impairment or dehydration; ensure adequate hydration prior to intravascular administration.
- Pregnancy: FDA Category B. Animal studies have not demonstrated fetal risk, but use in late pregnancy carries potential theoretical risk to fetal thyroid function.
- Laboratory Interference: Prior use of iohexol can reduce the iodine-binding capacity of thyroid tissue for up to 2 weeks, interfering with iodine-dependent thyroid function tests.
藥物相互作用
May cause additive prolongation of the QTc interval, though iohexol causes less prolongation than diatrizoate.
May alter binding to thyroid tissue for up to two weeks, affecting certain thyroid treatments or scans.
May increase the risk for lowering the seizure threshold, especially when iohexol is used intrathecally.
監測
- Signs of hypersensitivity or anaphylaxis during and immediately after administration
- Renal function (if pre-existing impairment exists)
- Hydration status
藥物動力學
半衰期
吸收
Rapidly distributed throughout the circulation after intravascular administration.
分佈
Volume of distribution (Vdss) in dogs is 221 mL/kg. Protein binding is very low (<1%). Distributed into milk in very low quantities.
代謝
Not significantly metabolized.
排除
Nearly 100% of a dose is excreted unchanged in the urine within 24 hours in patients with normal renal function. Mean clearance in dogs: 2.5-2.9 mL/kg/minute. Mean clearance in cats: 2.3-2.75 mL/kg/minute.
過量
Adverse effects of intravenous overdosage can be serious and life-threatening, primarily affecting the pulmonary and cardiovascular systems.
- Clinical Signs: Cyanosis, bradycardia, acidosis, pulmonary hemorrhage, convulsions, coma, and cardiac arrest.
- Treatment: Treatment is entirely supportive and symptomatic. Maintain airway, support ventilation, and manage cardiovascular collapse with appropriate fluids and vasopressors as needed.
可用產品
劑型
- Injection (preservative-free)
人用標示
- Iohexol Injection (preservative-free): 180 mg/mL, 240 mg/mL, 300 mg/mL & 350 mg/mL (organic iodine content) in various vials, bottles, syringes, or cartridges (Omnipaque)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature 25°C (68°F); excursions permitted between 15°-30°C. Protect from light.
飼主須知
什麼是碘海醇 (Iohexol)？ 碘海醇是一種特殊的醫療染劑（顯影劑），用於幫助獸醫師在 X 光或 CT 掃描中更清晰地觀察寵物的內部器官。它也被用作一種高度準確的測試，以測量寵物腎臟的運作情況。
- 安全性：這是一種現代的「低滲透壓」顯影劑，這意味著它對身體更加溫和，且副作用遠少於早期的染劑。
- 預期情況：如果用於影像學檢查，可能會透過口服、靜脈注射或注入特定的體腔內。如果用於腎功能測試，則會注射入靜脈，並在接下來的幾個小時內抽取幾次血液樣本，以觀察腎臟將其從血液中清除的速度。
- 副作用：寵物發生不良反應的情況極為罕見。然而，請注意是否有任何過敏反應的跡象（臉部腫脹、蕁麻疹、呼吸困難）或極度嗜睡，如果出現這些情況，請立即聯繫您的獸醫師。
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