An Expert Report on Iodixanol (Visipaque®): Pharmacology, Clinical Use, and Comparative Safety

Executive Summary

Iodixanol is a third-generation, non-ionic, dimeric, hexa-iodinated radiographic contrast agent representing a significant development in medical imaging.[1] Marketed principally under the brand name Visipaque®, its defining physicochemical characteristic is its iso-osmolality. At all clinically relevant concentrations, it is isotonic to human blood, with an osmolality of approximately 290 mOsm/kg H₂O, a feature unique among intravascular contrast media.[3] This property was engineered to improve the safety and tolerability profile of iodinated contrast agents, particularly in high-risk patient populations.[5]

Clinically, Iodixanol is utilized for a broad spectrum of intra-arterial and intravenous radiographic procedures. Its applications include angiography, venography, excretory urography, and contrast-enhanced computed tomography (CECT) of the head and body.[6] Notably, it is the only contrast agent with a specific U.S. Food and Drug Administration (FDA) approved indication for Coronary Computed Tomography Angiography (CCTA), positioning it as a key tool in the non-invasive diagnostic evaluation of coronary artery disease.[8]