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Rates of idiosyncratic reactions. Ionic versus nonionic contrast media

R L Siegle1

  • 1Department of Radiology, University of Texas Health Science Center at San Antonio 78284-7800.

Investigative Radiology
|November 1, 1993
PubMed

Insights

Nonionic iodinated contrast agents are safer than ionic agents, with significantly lower rates of idiosyncratic reactions. This finding is supported by extensive research comparing different contrast media types.

Area of Science:

  • Radiology
  • Pharmacology
  • Medical Imaging

Background:

  • Idiosyncratic reactions to iodinated contrast agents have been studied for nearly 40 years.
  • Conventional hyperosmolar agents have an estimated reaction rate of 5% and a repeat reaction rate exceeding 20%.

Purpose of the Study:

  • To compare the rates of idiosyncratic reactions between ionic and nonionic iodinated contrast agents.
  • To evaluate the safety profile of different types of iodinated contrast media.

Main Methods:

  • A comprehensive literature review was performed.
  • Included studies encompassed retrospective, prospective, and analytical multistudy reviews.

Main Results:

  • Large comparative studies from the late 1980s showed significantly lower idiosyncratic reaction rates with nonionic agents compared to conventional ionic agents.
  • Results regarding routine steroid administration before ionic agents were contradictory.
  • Analytical reviews questioned the methodology of some studies but supported the enhanced safety of nonionic agents.

Conclusions:

  • All iodinated contrast media possess excellent safety records.
  • The majority of evidence indicates that nonionic contrast agents offer superior safety compared to ionic agents.
Abstract

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