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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
Pediatric Cardiology
|May 9, 2001
Summary
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.