Acute adverse reactions of three intravenous lodinated contrast media in computed tomography under routine clinical monitoring: Iothalamate meglumine, iopromide and iohexol

Nonionic iodinated contrast media (NICM) is generally considered to have a much lower incidence of acute adverse drug reactions (aADRs) than ionic iodinated contrast media (IICM). Several studies have compared aADRs of IICM to NICM but few compared between different NICMs. There are few large local studies of adverse reactions to iodinated contrast media (ICM) in Taiwan. We undertook a retrospective study to compare the aADRs between different ICM in computed tomography (CT) under routine clinical monitoring. All consecutive patients who received intravenous contrast-enhanced CT scans using lothalamate meglumine, lopromide, or lohexol from May 2004 to February 2006 were enrolled. In total 32499 enrolled patients received either lothalamate meglumine (7520, 23.14%), lopromide (9830, 30.25%), or lohexol (15149, 46.61%). Two categories of injection rate were classified: rapid (>2 mL/sec) and slow (manual injection). Acute ADRs were classified by systemic symptoms. The statistical methods used were Fisher's exact test and Chi-squared test. Significantly increased aADR incidence was noted with lothalamate meglumine when compared with lopromide (p<0.001) and lohexol (p<0.00i). Comparing aADR incidence between different NICMs, lopromide had a higher total aADR incidence (p<0.001), and significantly increased incidence of gastrointestinal (p=0.005), cutaneous (p<0.001) and respiratory (p<0.001) aADR symptoms than that of lohexol. When comparing slow with rapid injection, a higher incidence of gastrointestinal symptoms was noted with slow injection than rapid injection of lopromide (p=0.008). In this study, lothalamate meglumine revealed a higher aADR incidence than lopromide and lohexol. In addition, compared to lohexol, lopromide had a higher total aADR incidence as well as gastrointestinal, cutaneous and respiratory aADR incidence.