# Metrizamide

> Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Metrizamide
> Markdown URL: https://mediated.wiki/source/Metrizamide.md
> Source: https://en.wikipedia.org/wiki/Metrizamide
> Source revision: 1329684997
> License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/)

Chemical compound

Pharmaceutical compound

Metrizamide Clinical data Trade names Amipaque Other names 3-aAcetamido-2,4,6-triiodo-5-(N-methylacetamido)-N-[(3R,4R,5S,6R)-2,4,5-trihydroxy-6-(hydroxymethyl)oxan-3-yl]benzamide AHFS/Drugs.com Micromedex Detailed Consumer Information ATC code V08AB01 (WHO) Identifiers IUPAC name 2-({3-(Acetylamino)-5-[acetyl(methyl)amino]-2,4,6-triiodobenzoyl}amino)-2-deoxy-D-glucopyranose CAS Number 31112-62-6 Y PubChem CID 443944 DrugBank DB01578 Y ChemSpider 391998 N UNII RHH3W8F1CO KEGG D01311 ChEMBL ChEMBL1200889 N CompTox Dashboard (EPA) DTXSID1023310 ECHA InfoCard 100.045.872 Chemical and physical data Formula C18H22I3N3O8 Molar mass 789.100 g·mol−1 NY (what is this?) (verify)

**Metrizamide** is a [non-ionic](/source/Non-ionic) iodine-based [radiocontrast agent](/source/Radiocontrast_agent).[1] It is also a density gradient medium for the [centrifugation](/source/Centrifugation) of biological particles.[2]

Historically metrizamide replaced both [iodized oil](/source/Iodized_oil) (trade names: Ethiodol, Lipiodol) and [iofendylate](/source/Iofendylate) (trade names: Pantopaque, Myodil) as the [contrast agent](/source/Contrast_agent) of choice for [myelography](/source/Myelography) (an [X-ray study](/source/X-ray_image) of the spine now largely replaced by [MRI](/source/Magnetic_resonance_imaging)). The radio opacity characteristics are such that finer detail is displayed with metrizamide, as well as the advantage of reabsorption from spinal fluid and excretion from the body – since unlike iofendylate, metrizamide is a water-soluble substance.

All three agents are administered by [lumbar puncture](/source/Lumbar_puncture) (also referred to as a spinal tap or cisternal puncture), at the cervicocranial junction. The human patient is rolled from the [lateral decubitus](/source/Lateral_decubitus) (lying on the side) to prone. Ankles are strapped to the end of a hard X-ray, [CT](/source/CT_scan), or MRI table. To obtain images of the [cervical region](/source/Neck) the patient is then carefully tilted in the [Trendelenberg position](/source/Trendelenburg_position) (head down) so the contrast agent (particularly iofendylate) can enter the neck region. Care is given to prevent spilling dye into the [posterior cranial fossa](/source/Posterior_cranial_fossa) (back of the head) or to enter the cranial cavity in general. This speaks to the inability to remove the heavier or more viscous iofendylate without aspirating it with [spinal fluid](/source/Spinal_fluid) through a lumbar puncture needle in the low back (sticking up vertically) or back of the neck. Removal of iofendylate is necessary since it is not water-soluble. With metrizamide the issue is that if entering the [cranial cavity](/source/Cranial_cavity) and high dose exposure to the [blood brain barrier](/source/Blood_brain_barrier), side effects are more likely encountered. Issues related to absorption into the general circulation are also encountered.

## Side effects

- Headache

- Nausea

- Vomiting

- [Mass effect](/source/Mass_effect_(medicine)), [herniation](/source/Herniation), and major central nervous system complications including spinal cord compression

- [Seizures](/source/Seizures)

- Muscle rigidity and [dystonic](/source/Dystonic) reaction

- [Aphasia](/source/Aphasia)[3]

- Adverse neurobehavioral reactions[4]

## History

Metrizamide was approved in the US in 1978. Its marketing is discontinued as of 2021.[5]

## References

1. **[^](#cite_ref-1)** Hanus, P. M. (1980). "Metrizamide: a review with emphasis on drug interactions". *American Journal of Hospital Pharmacy*. **37** (4): 510–513. [ISSN](/source/ISSN_(identifier)) [0002-9289](https://search.worldcat.org/issn/0002-9289). [PMID](/source/PMID_(identifier)) [6103672](https://pubmed.ncbi.nlm.nih.gov/6103672).

1. **[^](#cite_ref-Current_Protocols_in_Immunology_2-0)** Inaba, Kayo (2011). *Current Protocols in Immunology*. Isolation of Dendritic Cells: Wiley. p. 3.7.14.

1. **[^](#cite_ref-3)** Kassicieh et al. (1988), Conduction aphasia following metrizamide myelography, J Am Osteopath Assoc 1988 Vol. 88 Issue 3 Pages 384-6

1. **[^](#cite_ref-4)** Killebrew K, Whaley RA, Hayward JN, Scatliff JH (February 1983). "Complications of metrizamide myelography". *Archives of Neurology*. **40** (2): 78–80. [doi](/source/Doi_(identifier)):[10.1001/archneur.1983.04050020040007](https://doi.org/10.1001%2Farchneur.1983.04050020040007). [PMID](/source/PMID_(identifier)) [6824454](https://pubmed.ncbi.nlm.nih.gov/6824454).

1. **[^](#cite_ref-5)** ["Drugs@FDA: FDA-Approved Drugs: Amipaque"](https://web.archive.org/web/20170125221747/http://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=017982). [Food and Drug Administration](/source/Food_and_Drug_Administration). Archived from [the original](https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=017982) on January 25, 2017. Retrieved 2021-03-31.

## Further reading

- Ozdoba C, Gralla J, Rieke A, Binggeli R, Schroth G (2011). ["Myelography in the Age of MRI: Why We Do It, and How We Do It"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197073). *Radiology Research and Practice*. **2011** 329017. [doi](/source/Doi_(identifier)):[10.1155/2011/329017](https://doi.org/10.1155%2F2011%2F329017). [PMC](/source/PMC_(identifier)) [3197073](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197073). [PMID](/source/PMID_(identifier)) [22091378](https://pubmed.ncbi.nlm.nih.gov/22091378).

- Boyd WR, Gardiner GA (September 1977). "Metrizamide myelography". *AJR. American Journal of Roentgenology*. **129** (3): 481–4. [doi](/source/Doi_(identifier)):[10.2214/ajr.129.3.481](https://doi.org/10.2214%2Fajr.129.3.481). [PMID](/source/PMID_(identifier)) [409203](https://pubmed.ncbi.nlm.nih.gov/409203).

## External links

- ["Metrizamide"](http://medical-dictionary.thefreedictionary.com/metrizamide). *The Free Dictionary*.

- ["Metrizamide"](https://www.drugs.com/mmx/metrizamide.html). *Drugs.com*.

v t e Contrast media (V08) X-ray and CT Iodinated, Water soluble Nephrotropic, high osmolar Diatrizoic acid# Metrizoic acid Iodamide Iotalamic acid Ioxitalamic acid Ioglicic acid Acetrizoic acid Iocarmic acid Methiodal Diodone Nephrotropic, low osmolar Metrizamide Iohexol# Ioxaglic acid Iopamidol Iopromide Iotrolan Ioversol Iopentol Iodixanol Iomeprol Iobitridol Ioxilan Hepatotropic Iodoxamic acid Iotroxic acid# Ioglycamic acid Adipiodone Iobenzamic acid Iopanoic acid Iocetamic acid Sodium iopodate Tyropanoic acid Calcium iopodate Iodinated, Water insoluble Ethiodized oil (= Ethyl esters of iodised fatty acids, lipiodol) Iopydol Propyliodone Iofendylate‡ Non-iodinated Barium sulfate# MRI Paramagnetic Gadolinium-based: Gadobenic acid Gadobutrol Gadodiamide Gadofosveset Gadolinium Gadopentetic acid Gadopiclenol Gadoteric acid Gadoteridol Gadoversetamide Gadoxetic acid Other: Ferric ammonium citrate Mangafodipir‡ Superparamagnetic Ferumoxsil Ferristene Iron oxide, nanoparticles Other Perflubron Ultrasound Microspheres of human albumin Microparticles of galactose Perflenapent Microspheres of phospholipids Sulfur hexafluoride #WHO-EM ‡Withdrawn from market Clinical trials: †Phase III §Never to phase III

---
Adapted from the Wikipedia article [Metrizamide](https://en.wikipedia.org/wiki/Metrizamide) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Metrizamide?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.