Interactions : אינטראקציות

4.5      Interaction with other medicinal products and other forms of interaction

Biguanides (metformin): in patients with acute kidney injury or severe chronic kidney disease, biguanide elimination may be disrupted, leading to accumulation and the development of lactic acidosis. As the use of Ultravist may lead to renal impairment or aggravation of renal impairment, patients treated with metformin may be at an increased risk of developing lactic acidosis, especially those with pre-existing renal impairment (see section “Special warnings and precautions for use” – under 'Intravascular use' – 'Acute kidney injury' ). The administration of metformin should be discontinued temporarily, at the latest from the time of administration of the iodinated contrast medium, in patients with eGFR < 30 ml/min./1.73 m2 when administration is intravenous or intraarterial with second pass renal exposure to the iodinated contrast media, or in patients with eGFR < 45 ml/min./1.73 m2 when administration is with first pass renal exposure. Metformin should be resumed 48 hours after administration of the contrast medium if serum creatinine/eGFR has not changed from the pre-imaging levels. If the eGFR is higher than these values, the metformin may be continued provided hydration is adequate.


Interleukin-2: previous interleukin-2 treatment (up to several weeks previously) is associated with an increase in the risk of delayed reactions to Ultravist.

Radioisotopes: the diagnosis and treatment of thyroid disorders with thyrotropic radioisotopes may be impeded for several weeks after the administration of Ultravist due to reduced radioisotope uptake.

Nephrotoxic medicines: the use of nephrotoxic medicines (for example NSAIDs, aminosides, cisplatin) should be discontinued temporarily when examining patients with eGFR < 30 ml/min./1.73 m2 in the case of intravenous or intraarterial administration with second pass renal exposure to iodinated contrast media, or in patients with eGFR < 45 ml/min./1.73 m2 in the case of first pass renal exposure.