Posology : מינונים

4.2      Posology and method of administration

•     General information

Experience shows that contrast medium is tolerated better if it is warmed to body temperature.
Intravenous urography

Adults: The minimum dose is 0.8ml/kg body weight Ultravist 370, (1ml/kg Ultravist 300). These doses should provide adequate filling of the ureters. It may be necessary to increase the dose in individual cases.

Children: The poor concentrating ability of the immature nephron of infantile kidneys necessitates the use of relatively high doses of contrast medium, i.e. for Ultravist 300: Neonates:                                     4.0 ml/kg body weight
Babies:                                       3.0 ml/kg body weight
Small children:                               1.5 ml/kg body weight

Computerised tomography

Cranial CT: The following dosages are recommended for cranial CT:
Ultravist 300:                     1-2ml/kg body weight
Ultravist 370:                     1-1.5ml/kg body weight
Whole-body CT: For whole-body computerised tomography, the doses of contrast medium and the rates of administration depend on the organs under investigation, the diagnostic problem and, in particular, the different scan and image-reconstruction times of the scanners in use.

Angiography: The dosage depends on the age, weight, cardiac output and general condition of the patient, the clinical problem, examination technique and the nature and volume of the vascular region to be investigated.

The following dosages may serve as a guide:

Cerebral angiography
Aortic arch angiography                       50-80 ml Ultravist 300/inj.
Selective angiography                         6-15 ml Ultravist 300/inj.
Thoracic aortography:                         50-80 ml Ultravist 300/inj.
Abdominal aortography:                        40-60 ml Ultravist 300/inj.

Peripheral angiography:
Upper extremities:
Arteriography                                 8-12 ml Ultravist 300/inj.
Venography                                    15-30 ml Ultravist 300/inj.

Lower extremities:
Arteriography                                 20-30 ml Ultravist 300/inj.
Venography                                    30-60 ml Ultravist 300/inj.
Angiocardiography:
Cardiac-ventriculography                      40-60 ml Ultravist 370/inj.
Coronary angiography:                         5-8 ml Ultravist 370/inj.

Digital subtraction angiography (DSA): I.V. injection of 30-60 ml Ultravist 300 or 370 as a bolus (flow-rate: 8-12 ml/second into the cubital vein; 10-20 ml/second into the vena cava) is recommended for high-contrast demonstrations of the great vessels, of the pulmonary arteries and of the arteries of the neck, head, kidneys and extremities.
Intra-arterial digital subtraction angiography requires smaller volumes and lower iodine concentrations than the intravenous technique.
Additional information on special populations

•   Paediatric population

Young infants (age < 1 year) and especially newborns are susceptible to electrolyte imbalance and haemodynamic alterations. Care should be taken regarding the dose of contrast medium to be given, the technical performance of the radiological procedure and the patient status (see section 5.2).

•   Patients with renal impairment

Since iopromide is excreted almost exclusively in an unchanged form via the kidneys, the elimination of iopromide is prolonged in patients with renal impairment. In order to reduce the risk of additional contrast media-induced renal impairment in patients with pre-existing renal impairment, the minimum possible dose should be used in these patients (see also sections 4.4, 5.1 and 5.2).

•   Patients with hepatic impairment

No dosage adjustment is necessary in patients with hepatic impairment (see section 5.2).

•   Elderly

When administered to elderly patients, the possibility of reduced renal function (leading to reduced clearance) should be considered (see section 5.2).