Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction
To prevent onset of lactic acidosis in diabetic patients being treated with oral anti-diabetic agents of the biguanide class (metformin), these agents should be discontinued prior to intra-arterial administration of contrast medium with first-pasbs renal exposure, or in patients with acute kidney injury, and only reinstituted after 48 hours if renal function has not changed significantly.
(See 4.4 Special warnings and precautions for use: Special populations).

Following administration of iopamidol atypical adverse reactions e.g. erythema, fever and flu symptoms have been reported in patients treated with interleukin-2 and interferon.

Following administration of iopamidol, the capacity of the thyroid tissue to take up iodine is reduced for 2-6 weeks.

Arterial thrombosis has been reported when iopamidol was given following papaverine. The administration of vasopressors strongly potentiates the neurological effects of intra-arterial contrast media.

Renal toxicity has been reported in patients with liver dysfunction who were given oral cholecystographic agents followed by intravascular contrast agents.
However, recent studies have not shown interactions of contrast agents excreted by the kidney with oral cholecystographic contrast agent.

Contrast media may interfere with laboratory tests for bilirubin, proteins or inorganic substances (e.g. iron, copper, calcium, and phosphate). These substances should not be assayed during the same day following the administration of contrast media.

In patients receiving beta-blockers there is an elevated risk of more severe anaphylactoid reactions.

Beta-blockers may impair the management of bronchospasm and the response to adrenaline.

Consider stopping treatment with drugs that lower the epileptogenic threshold up to 24 hours after the procedure for intrathecal use and for patients with blood-brain barrier disorders (see section 4.4 Special warnings and precautions for use: CNS disorders).

Alcoholism or drug addiction increase the permeability of the blood brain barrier. This facilitates the passage of iodinated agents in brain tissue with possible CNS disorders. A possible lowering of seizure threshold should be kept in mind.