Preparation of the patient: Appropriate preparation is desirable for optimal results. A laxative the night before the examination and a low residue diet the day before the procedure are recommended. Dosage: The dose for retrograde use in cystography and voiding cystourethrography ranges from 25 to 300 mL depending on the age of the patient and the degree of bladder irritability; amounts greater than 300 mL may be ...
For retrograde cystourethrography Not intended for intravascular injection
DESCRIPTION
DESCRIPTION SECTION
Cystografin is a radiopaque contrast
agent supplied as a sterile, clear, colorless to pale yellow, mobile
or slightly viscous solution. Each mL provides 300 mg diatrizoate
meglumine with 0.4 mg edetate disodium as a sequestering agent. Each
mL of solution also contains approximately 141 mg organically bound
iodine. At the time of manufacture, the air in the container is replaced
by nitrogen. The preparation should be protected from strong light.
INDICATION
INDICATIONS & USAGE SECTION
Cystografin is indicated for retrograde
cystourethrography.
CONTRAINDICATIONS
CONTRAINDICATIONS SECTION
This preparation is contraindicated
in patients with a hypersensitivity to salts of diatrizoic acid.
WARNINGS
WARNINGS SECTION
Severe sensitivity reactions are
more likely to occur in patients with a personal or family history
of bronchial asthma, significant allergies, or previous reactions
to contrast agents.
A
history of sensitivity to iodine per se or to other
contrast agents is not an absolute contraindication to the use of
diatrizoate meglumine, but calls for extreme caution in administration.
PRECAUTIONS
PRECAUTIONS SECTION
Safe and effective use of this
preparation depends upon proper dosage, correct technique, adequate
precautions, and readiness for emergencies.
Retrograde cystourethrography should be performed
with caution in patients with a known active infectious process of
the urinary tract.
Sterile
technique should be employed in administration. During administration,
care should be taken to avoid excessive pressure, rapid or acute distention
of the bladder, and trauma.
Contrast agents may interfere with some chemical determinations made
on urine specimens; therefore, urine should be collected before administration
of the contrast medium or two or more days afterwards.
Pregnancy—Teratogenic Effects:
TERATOGENIC EFFECTS SECTION
Animal reproduction studies have not been conducted
with diatrizoate meglumine injection. It is also not known whether
diatrizoate meglumine injection can cause fetal harm when administered
to a pregnant woman or can affect reproduction capacity. Cystografin
should be administered to a pregnant woman only if clearly needed.
ADVERSE REACTIONS
ADVERSE REACTIONS SECTION
Retrograde genitourinary procedures
may cause such complications as hematuria, perforation of the urethra
or bladder, introduction of infection into the genitourinary tract,
and oliguria or anuria.
If intravasation of this drug occurs, the reactions which may be
associated with intravenous administration may possibly be encountered.
Hypersensitivity or anaphylactoid reactions may occur. Severe reactions
may be manifested by edema of the face and glottis, respiratory distress,
convulsions or shock; such reactions may prove fatal unless promptly
controlled by such emergency measures as maintenance of a clear airway
and immediate use of oxygen and resuscitative drugs.
Endocrine: Thyroid function tests indicative of hypothyroidism or transient
thyroid suppression have been uncommonly reported following iodinated
contrast media administration to adult and pediatric patients, including
infants. Some patients were treated for hypothyroidism.
DOSAGE AND ADMINISTRATION
DOSAGE & ADMINISTRATION SECTION
SPL UNCLASSIFIED SECTION
Preparation of the patient: Appropriate preparation is desirable for optimal results. A laxative
the night before the examination and a low residue diet the day before
the procedure are recommended.
SPL UNCLASSIFIED SECTION
Dosage: The dose for
retrograde use in cystography and voiding cystourethrography ranges
from 25 to 300 mL depending on the age of the patient and the degree
of bladder irritability; amounts greater than 300 mL may be used if
the bladder capacity allows. Best results are obtained when the bladder
is filled with the contrast agent. If desired, the preparation may
be diluted with sterile water or sterile saline as indicated in the
table below.
SPL UNCLASSIFIED SECTION
Administration: After
sterile catheterization, the bladder should be filled to capacity
with Cystografin using a suitable sterile administration set. Care
should be taken to avoid using excessive pressure. The presence of
bladder discomfort or reflux and/or spontaneous voiding usually indicates
that the bladder is full.
SPL UNCLASSIFIED SECTION
Radiography: The commonly
employed radiographic techniques should be used. A scout film is recommended
before the contrast agent is administered.
Dilution Table
USE DILUTED
SOLUTIONS IMMEDIATELY
100 mL Bottle
Sterile Water or Sterile Saline
Added
% Diatrizoate Meglumine w/v
% Organically Bound Iodine w/v
Total Volume
0 mL
30.0
14.1
100 mL
25 mL
24.0
11.3
125 mL
50 mL
20.0
9.4
150 mL
67 mL
18.0
8.5
167 mL
300 mL Bottle
Sterile Water or Sterile Saline
Added
0 mL
30.0
14.1
300 mL
50 mL
25.7
12.1
350 mL
HOW SUPPLIED
HOW SUPPLIED SECTION
Cystografin (Diatrizoate Meglumine
Injection USP 30%) is available in 200 mL and 400 mL bottles containing
100 mL and 300 mL of Cystografin respectively with sufficient capacity
for dilution up to 167 mL and 350 mL respectively.
Storage
STORAGE AND HANDLING SECTION
Store at 20-25°C (68-77°F) [See
USP]. Protect from light.
Also Available
SPL UNCLASSIFIED SECTION
Cystografin Dilute (Diatrizoate
Meglumine Injection USP 18%) is also available, as a 300 mL fill in
a 400 mL bottle.
SPL UNCLASSIFIED SECTION
Revised June 2024
Rx only
Manufactured for Bracco Diagnostics Inc. Princeton, NJ 08540
by Patheon Italia S.p.A. 03013 Ferentino (Italy)
PACKAGE LABEL.PRINCIPAL DISPLAY PANEL
Cystografin 100 mL Label NDC 0270-0149-60
Cystografin 100 mL Label
Cystografin 1 Box 10 Bottles — 300 mL each NDC 0270-0149-57
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