Posology : מינונים

4.2    Posology and method of administration

The dosage vary depending on the type of examination age, weight, cardiac output and general condition of the patient and the technique used. Usually, the same iodine concentration and volume is used as with other iodinated X-ray contrast media in current use. Adequate hydration should be assured before and after administration as for other contrast media.
For intravenous, intra-arterial and intrathecal use, and use in body cavities.
The following dosages may serve as a guide:



Guidelines for intravenous use

Indication           Concentration           Volume                     Comments Urography
 adults:               300 mg I/ml         40 - 80 ml                   80 ml may be or 350 mg I/ml      40 - 80 ml                   exceeded in selected cases children < 7 kg       240* mg I/ml        4 ml/kg b.w.
or 300 mg I/ml      3 ml/kg b.w.
 children > 7 kg       240* mg I/ml        3 ml/kg b.w.
or 300 mg I/ml      2 ml/kg b.w.
(max 40 ml)

Phlebography (leg)    240* mg I/ml        20 - 100 ml/leg or 300 mg I/ml


Digital subtraction   300 mg I/ml         20 - 60 ml/inj.
angiography           or 350 mg I/ml      20 - 60 ml/inj.
CT-enhancement adults:               240* mg I/ml        100 - 250 ml                 Total amount of or 300 mg I/ml      100 - 200 ml                 iodine or 350 mg I/ml      100 - 150 ml                 usually 30 - 60 g  children:             240* mg I/ml        2-3 ml/kg b.w. up to 40 ml   In a few cases up to or 300 mg I/ml      1-3 ml/kg b.w. up to 40 ml   100 ml may be given 

Guidelines for intra-arterial use

Indication          Concentration           Volume                    Comments 
Arteriographies
 arch aortography       300 mg I/ml         30 - 40 ml/inj.              Volume per injection selective cerebral     300 mg I/ml         5 - 10 ml/inj.               depends on the site aortography            350 mg I/ml         40 - 60 ml/inj.              of injection femoral                300 mg I/ml         30 - 50 ml/inj.
or 350 mg I/ml
 various                300 mg I/ml         depending on type of examination



Indication           Concentration               Volume                Comments 
Cardioangiography
 adults: left ventricle and    350 mg I/ml             30 - 60 ml/inj.
aortic root inj.
selective coronary    350 mg I/ml              4 - 8 ml/inj.
arteriography depending on age,
children:             300 mg I/ml             weight and pathology or 350 mg I/ml          (max 8 ml/kg b.w.)
 depending on site of
Digital subtraction   240* mg I/ml             1 - 15 ml/inj.           inj. occasionally large angiography           or 300 mg I/ml           1 - 15 ml/inj.           volumes - up to 30 ml - may be used

Guidelines for intrathecal use

Indication            Concentration           Volume                    Comments 
Lumbar and            240* mg I/ml             8 – 12 ml thoracic myelography
(lumbar injection)

Cervical              240* mg I/ml            10-12 ml myelography           or 300 mg I/ml          7 - 10 ml
(lumbar injection)
Cervical              240* mg I/ml            6 - 10 ml myelography           Or 300 mg I/ml          6 - 8 ml
(lateral cervical injection)

CT cisternography                            4 - 12 ml
(lumbar               240* mg I/ml injection)



To minimize possible adverse reactions a total dose of 3 g iodine should not be exceeded.
Guidelines for body cavities


Indication            Concentration           Volume                    Comments 
Arthrography             300 mg I/ml          5 - 15 ml or 350 mg I/ml          5 - 10 ml

ERP/ERCP                240* mg I/ml            20 - 50 ml


Herniography            240* mg I/ml            50 ml                      The dosage varies with the size of the hernia


Hysterosalpingog        240* mg I/ml            15 - 50 ml raphy                or 300 mg I/ml             15 - 25 ml

Sialography             240* mg I/ml            0.5 - 2 ml or 300 mg I/ml             0.5 - 2 ml

Gastrointestinal studies
Oral use
Adults:                350 mg I/ml             Individual                 Max. dose 50 ml Max. dose 50 ml

Children:
- oesophagus             300 mg I/ml            2-4 ml/kg b.w.
or 350 mg I/ml            2-4 ml/kg b.w.

Prematures:            350 mg I/ml             2-4 ml/kg b.w.
Rectal use
- children:          dilute with tap-water to   5-10 ml/kg b.w.
100-150 mg I/ml                                       Example:
Dilute 240*, 300 or
350 with tap-water 1:1 or 1:2

CT- enhancement

Oral use
- adults:            Dilute with tap water to   800-2000 ml of the         Example: ~6mgI/ml                   diluted solution over a    Dilute Kopaq 300 or period of time             350 with tap water 1:50
- children:          Dilute with tap water to   15-20 ml/kg b.w. of the ~6mgI/ml                   diluted solution

Rectal use
- children:          Dilute with tap water to   individual
~6mgI/ml
* Use the commercial product available on the market

For elderly patients, patients with hepatic and/or renal impairments, the usual/proposed doses for adults can be used.