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Published on: August 15, 2016
Iodixanol pharmacokinetics in children
W H Johnson1, T R Lloyd, B E Victorica
1Department of Pediatrics, LM Bargeron Division of Pediatric Cardiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. wjohnson@uab.edu
The elimination of iodixanol (Visipaque) in children under six months is slower due to immature renal clearance. Older children and adults show comparable iodixanol elimination rates, indicating age-related pharmacokinetic differences.
Area of Science:
- Pharmacokinetics
- Pediatric Nephrology
- Radiology
Background:
- Iodixanol is an iso-osmolar iodinated radiocontrast agent used in medical imaging.
- Understanding its elimination in pediatric populations is crucial for safe administration.
- Renal function in children matures with age, potentially affecting drug clearance.
Purpose of the Study:
- To investigate the elimination pharmacokinetics of iodixanol in pediatric patients.
- To determine if age-related differences in renal clearance influence iodixanol elimination.
- To compare iodixanol elimination in different pediatric age groups and with adult data.
Main Methods:
- A multi-center study involving 43 pediatric patients undergoing cardiac catheterization or cranial CT.
- Patients were categorized into five age groups, from newborns to 12 years old.
- Plasma samples were analyzed using high-performance liquid chromatography to determine iodixanol concentrations and calculate the terminal elimination rate constant (kel).
Main Results:
- The terminal elimination rate constant (kel) was significantly lower in infants younger than 2 months compared to older children.
- Elimination half-life (t1/2 beta) was prolonged in infants <6 months (4.14 ± 1.41 h) versus older children (2.23–2.79 h).
- Iodixanol elimination in children >6 months of age was comparable to that observed in normal adults.
Conclusions:
- Age-related differences in renal clearance significantly impact iodixanol elimination in children.
- Renal immaturity in infants <6 months leads to prolonged elimination of iodixanol.
- Iodixanol exhibits predictable and age-appropriate elimination in pediatric patients >6 months of age.
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