Diagnostic procedures which involve the use of radiopaque diagnostic agents should be carried out under the direction of personnel with the prerequisite training and with a thorough knowledge of the particular procedure to be performed.
In patients having or suspected of having carcinoma of the uterus and/or uterine tubes, the possible dispersion of carcinogenic cells during hysterosalpingography should be borne in mind.
The possibility of a reaction should always be considered. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity: bronchial asthma, hay fever, and food allergies. A positive history of allergies or hypersensitivity does not arbitrarily contraindicate the use of a contrast agent where a diagnostic procedure is thought essential, but caution should be exercised (see ADVERSE REACTIONS, and PRECAUTIONS, Information for the Patient).
Information for the Patient
Patients receiving diagnostic agents for intrauterine radiography should be given the following information:
- This drug has been prescribed to perform an X-ray study of the uterus and uterine tubes.
- Patients should be questioned regarding a recent history (within 30 days) of curettage or conization, pregnancy or a recent history (within six months) of termination of pregnancy, and a history of allergy to iodine, any foods, or X-ray dyes.
- Patients should consult the physician if, at some future date, any thyroid tests are planned. The iodine in this agent may interfere with some thyroid tests.
- This drug may cause adverse reactions (see ADVERSE REACTIONS) in some patients but most reactions are mild and pass quickly.
Drug/Laboratory Test Interactions
Thyroid Function Tests
Because a small amount of this medium may be absorbed, thyroid function tests such as protein bound iodine (PBI) and radioactive iodine uptake, if indicated, generally should be performed prior to instillation. However, thyroid function can be evaluated after use of any iodinated contrast agents by using T3 resin uptake or free thyroxine assays.
Diatrizoate meglumine and iodipamide meglumine administered intravascularly has been found to be excreted in breast milk.
Because small amounts of these agents may be absorbed following intrauterine instillation, caution should be exercised when any diagnostic intrauterine radiopaque agent is administered to a nursing woman.
Safety and effectiveness of hysterosalpingography has not been established in pediatric patients.