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Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media.
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1990
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PharmacotherapyAdverse Drug ReactionDrug HypersensitivityContrast MediaToxicologyClinical ChemistryRadiologyDrug SafetySevere AdrsOphthalmologyContrast AgentJapanese CommitteeSide EffectAdverse Drug ReactionsPatient SafetyForensic ToxicologyMedicineIonic Contrast MediaAdverse ReactionsAnesthesiology
A nationwide prospective study of 337,647 Japanese imaging examinations compared high‑osmolar ionic and low‑osmolar nonionic contrast media, with 169,284 ionic and 168,363 nonionic cases. The study found that ADRs occurred in 12.66% of ionic and 3.13% of nonionic cases, with severe ADRs in 0.22% versus 0.04%, and concluded that nonionic media markedly reduce severe and potentially life‑threatening reactions, making them the safest option.
A large-scale (337,647 cases), nationwide comparative clinical study in Japan on adverse drug reactions (ADRs) to high-osmolar ionic contrast media and low-osmolar nonionic contrast media was performed prospectively. Ionic contrast media were administered in 169,284 cases (50.1%) and nonionic contrast media in 168,363 cases (49.9%). The overall prevalence of ADRs was 12.66% in the ionic contrast media group and 3.13% in the nonionic contrast media group. Severe ADRs occurred in 0.22% of the ionic and 0.04% of the nonionic contrast media examinations. One death occurred in each group, but a causal relationship to the contrast medium could not be established. It is concluded that nonionic contrast media significantly reduce the frequency of severe and potentially life-threatening ADRs to contrast media at all levels of risk and that use of these media represents the most effective means of increasing the safety of contrast media examinations.