Iodised Oil

(BANM, rINNM)

💊 Chemical information

Aceite yodado; Ethiodized Oil.
CAS — 8001-40-9 (iodised oil); 8008-53-5 (ethiodized oil injection).
ATC — V0 8AD01.
ATC Vet — QV0 8AD01.

Description.

Iodised oil is an iodine addition product of the ethyl esters of the fatty acids obtained from poppy-seed oil. It contains about 35 to 39% of combined iodine.

Incompatibility.

Because of its solvent action on polystyrene, iodised oil injection should not be given in syringes made with polystyrene.

💊 Adverse Effects and Precautions

The risk of hypersensitivity reactions or iodism is greater after the use of iodised oil than after water-soluble iodinated contrast media such as the amidotrizoates. Pulmonary oil embolism is reported to be relatively frequent after lymphography but is not usually severe; however, hypotension, tachycardia, and pulmonary oedema and infarction may occur rarely and deaths have been reported in patients with pulmonary disease. Chemical pneumonitis, oedema, granuloma formation, and goitre have occurred. Great care must be taken to avoid vascular structures, because of the danger of oil embolism; it should therefore not be used in areas affected by haemorrhage or local trauma. Iodised oil should be used with care in patients with thyroid dysfunction or a history of allergic reactions. Use may interfere with thyroid-function tests for several months.

Hysterosalpingography.

The use of oily contrast media such as iodised oil for hysterosalpingography has been associated with serious adverse effects, including tubal occlusion,1 and cerebral and pulmonary oil embolism,2,3 and water-soluble contrast media are usually preferred. However, diagnostic hysterosalpingography using iodised oil has been associated with an increase in fertility4 and randomised trials5,6 using iodised oil for treatment in patients with unexplained infertility have found a similar effect.
1. Wright FW, Stallworthy J. Female sterility produced by investigation. BMJ 1973; 3: 632
2. Dan U, et al. Cerebral embolization and coma after hysterosalpingography with oil-soluble contrast medium. Fertil Steril 1990; 53: 939–40
3. Uzun O, et al. Pulmonary and cerebral oil embolism after hysterosalpingography with oil soluble contrast medium. Respirology 2004; 9: 134–6
4. Johnson NP. A review of the use of lipiodol flushing for unexplained infertility. Treat Endocrinol 2005; 4: 233–43
5. Nugent D, et al. A randomized controlled trial of tubal flushing with lipiodol for unexplained infertility. Fertil Steril 2002; 77: 173–5
6. Johnson NP, et al. The FLUSH trial—flushing with lipiodol for unexplained (and endometriosis-related) subfertility by hysterosalpingography: a randomized trial. Hum Reprod 2004; 19: 2043–51.

💊 Pharmacokinetics

Iodised oil may persist in the body for several weeks or months. It is only slowly absorbed from most body sites, although absorption from the peritoneal cavity is stated to be relatively rapid. It is reported to be slowly metabolised to fatty acids and iodine.

💊 Uses and Administration

Iodised oil is an iodinated radiographic contrast medium that is used mainly for lymphography. It has been used for hysterosalpingography but water-soluble agents are preferred. Although some preparations have been used in bronchography, the fluid injection of iodised oil is unsuitable for such use. Doses are dependent upon the procedure. Because it is slowly metabolised to release iodine, iodised oil is used in the management of iodine deficiency.

Infertility.

For reference to the use of iodised oil in the management of infertility, see Hysterosalpingography under Adverse Effects and Precautions, above.

Malignant neoplasms.

Intra-arterial injection of iodised oil has been used in both the diagnosis and management of malignant neoplasms of the liver. After injection into the hepatic artery, iodised oil is selectively retained by hepatic carcinomas and may have a role as an adjunct to computed tomography for both diagnosis and monitoring.1-3 It has also been used in the management of hepatic carcinoma,2,4 either to increase the retention of antineoplastics (chemoembolisation),5 or to provide targeted delivery of radioactive iodine.6
1. Dalla Palma L. Diagnostic imaging and interventional therapy of hepatocellular carcinoma. Br J Radiol 1998; 71: 808–18
2. Ryder SD. Guidelines for the diagnosis and treatment of hepatocellular carcinoma (HCC) in adults. Gut 2003; 52 (suppl): iii1–iii8. Also available at: http://www.bsg.org.uk/ pdf_word_docs/hcc.pdf (accessed 27/03/06
3. Zheng X-H, et al. Detection of hypervascular hepatocellular carcinoma: comparison of multi-detector CT with digital subtraction angiography and Lipiodol CT. World J Gastroenterol 2005; 11: 200–203
4. Trinchet JC, et al. Review article: intra-arterial treatments in patients with hepatocellular carcinoma Aliment Pharmacol Ther 2003; 17 (suppl 2): 111–118
5. Group d’Etude et de Traitement du Carcinome Hépatocellulaire. A comparison of Lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 1995; 332: 1256–61
6. Lau WY, et al. Adjuvant intra-arterial iodine-131-labelled lipiodol for resectable hepatocellular carcinoma: a prospective randomised trial. Lancet 1999; 353: 797–801.

💊 Preparations

BP 2008: Iodised Oil Fluid Injection; USP 31: Ethiodized Oil Injection.

Proprietary Preparations

Arg.: Lipiodol; Austral.: Lipiodol; Austria: Lipiodol; Belg.: Lipiodol; Braz.: Lipiodol†; Chile: Lipiodol; Cz.: Lipiodol; Denm.: Lipiodol; Fr.: Lipiodol; Ger.: Lipiodol; Gr.: Lipiodol; Hung.: Lipiodol; Israel: Lipiodol; Ital.: Lipiodol; Neth.: Lipiodol; Norw.: Lipiodol†; NZ: Lipiodol; Port.: Lipiodol; Switz.: Lipiodol; UK: Lipiodol; USA: Ethiodol; Venez.: Lipiodol.
Published November 23, 2018.