warnings
WARNINGS Dehydration: Administration of hypertonic diatrizoate meglumine and diatrizoate sodium solutions may lead to hypovolemia and hypotension due to fluid loss from the intestine. A 1 in 4.6 (1:4.6) dilution of diatrizoate meglumine and diatrizoate sodium yields an approximately isotonic 16.5 percent diatrizoate salts solution; less dilute solutions are hypertonic and may lead to intraluminal movement of fluid with resulting hypovolemia. In young or debilitated children and in elderly cachectic persons, the loss of plasma fluid may be sufficient to cause a shock-like state. If diatrizoate meglumine and diatrizoate sodium solution is used in infants and children (under 10 kg) or in dehydrated or debilitated patients, the solution must be prepared using the specific dilutions described in DOSAGE AND ADMINISTRATION. In debilitated patients and in patients with electrolyte imbalances, postprocedural monitoring of hydration, serum osmolarity, electrolytes and clinical status is essential. In pediatric or severely debilitated patients, the maintenance of an open intravenous fluid line for rehydration may be advisable should hypotension or shock supervene. Electrolyte disturbances must be corrected prior to the administration of any hypertonic diatrizoate meglumine and diatrizoate sodium solutions. Aspiration: Aspiration of diatrizoate meglumine and diatrizoate sodium solution into the trachea and airways may result in serious pulmonary complications including, pulmonary edema, pneumonitis or death bronchial entry of any orally administered contrast medium causes a copious osmotic effusion. Therefore, avoid use of diatrizoate meglumine and diatrizoate sodium solution in patients with esophagotracheal fistula and minimize risks for pulmonary aspiration in all patients. If diatrizoate meglumine and diatrizoate sodium solution is given by nasogastric tube, the position of the tube in the stomach must be verified before administration. Anaphylactic reactions: Anaphylactic reactions, including fatalities, have been reported with the use of diatrizoate meglumine and diatrizoate sodium solution. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Medical personnel trained in the treatment of anaphylactic reactions and the necessary drugs and medical equipment should always be readily available when diatrizoate meglumine and diatrizoate sodium solution is used.