Lipiodol Ultra-Fluid (Ethyl Esters Of Iodised Fatty Acids From Poppyseed Oil)

Lipiodol Ultra-Fluid, an iodinated oil-based contrast agent, is employed in radiographic procedures that require detailed visualization of vascular, lymphatic and hepatobiliary systems.

• Lymphangiography: enables high-resolution imaging of lymphatic vessels and nodes for diagnostic assessment.
• Hepatobiliary imaging: provides selective opacification of the biliary tree to evaluate liver and gallbladder disorders.
• Tumor embolization and chemoembolization: serves as a carrier for embolic particles or chemotherapeutic agents to occlude tumor blood supply and enhance local drug delivery.

• Ethiodized oil contains a high concentration of iodine atoms bound to fatty‑acid esters, creating a dense radiopaque substance. When injected intra‑arterially, intralymphatically, or intramuscularly, the oil remains localized within the target vascular or lymphatic bed, and its iodine absorbs X‑ray photons, producing a stark contrast between the filled structures and surrounding tissues. This property allows clinicians to delineate anatomy and monitor the distribution of embolic or therapeutic agents during interventional procedures.

Adverse reactions to Lipiodol Ultra-Fluid are generally related to its iodine content and oil vehicle.

Common Side Effects

• Injection site pain or burning sensation.
• Transient fever or chills.
• Nausea or mild vomiting.
• Headache.
• Mild skin rash or urticaria.
• Temporary thyroid function changes (subclinical hyper- or hypothyroidism).

Serious or Rare Side Effects

• Severe allergic reaction or anaphylaxis.
• Pulmonary embolism from oil migration.
• Acute renal impairment, especially in patients with pre-existing kidney disease.
• Significant thyroid dysfunction (iodine-induced thyrotoxicosis or hypothyroidism).
• Vascular occlusion leading to tissue necrosis.
• Cardiovascular collapse or hypotension.

Prior to using Lipiodol Ultra-Fluid, clinicians should evaluate patient history and clinical status to minimize risks.

• Allergy assessment: confirm no known iodine or oil‑based contrast allergy.
• Thyroid evaluation: assess baseline thyroid function in patients with thyroid disease.
• Renal function: check kidney function, especially in those with chronic renal insufficiency.
• Pregnancy and lactation: avoid use unless benefits outweigh potential risks, as safety data are limited.
• Concomitant therapies: use caution with radioactive iodine treatment or thyroid hormone replacement.
• Monitoring: observe patients for immediate hypersensitivity reactions during and after administration.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Lipiodol Ultra-Fluid may interact with certain medications or therapies that affect iodine handling or organ function.

Major Interactions (Avoid)

• Radioactive iodine therapy: excess iodine can diminish therapeutic efficacy.
• Thyroid hormone replacement (levothyroxine) or antithyroid drugs: may precipitate thyroid dysfunction.
• Nephrotoxic agents (e.g., aminoglycosides, amphotericin B): increase risk of renal impairment.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may mask tachycardia associated with contrast reactions.
• Diuretics: can alter fluid balance during intra‑arterial administration.
• Corticosteroids: may reduce severity of allergic responses, requiring dose adjustment.
• ACE inhibitors: monitor blood pressure as contrast may potentiate hypotensive effects.