What is the recommended dosing of Omnipaque (iohexol) for a CT neck scan?

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Last updated: December 17, 2025View editorial policy

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Omnipaque Dosing for CT Neck

The provided evidence does not contain specific dosing recommendations for CT neck imaging with Omnipaque (iohexol), as all guideline references address iohexol plasma clearance measurement protocols for GFR assessment, not diagnostic CT imaging protocols.

Critical Context Issue

The available evidence exclusively discusses:

  • Iohexol administration for measuring glomerular filtration rate (GFR), which uses standardized small volumes (5 mL of Omnipaque 300, containing 3235 mg iohexol total) for pharmacokinetic blood sampling 1
  • Laboratory calibration procedures for iohexol assays 2
  • Contrast allergy management unrelated to dosing 3

These protocols are fundamentally different from diagnostic CT imaging, where contrast volumes are substantially larger and weight-based.

Standard CT Neck Dosing (General Medical Knowledge)

For CT neck angiography with Omnipaque, typical dosing is:

  • Volume: 75-100 mL of Omnipaque 300 or 350
  • Injection rate: 3-5 mL/second
  • Total iodine load: Approximately 300-350 mg iodine/kg body weight
  • Timing: 25-30 second delay for arterial phase imaging

For CT neck soft tissue (non-angiographic):

  • Volume: 100-150 mL of Omnipaque 300 or 350
  • Injection rate: 1-3 mL/second
  • Timing: 60-90 second delay for venous phase

Available Omnipaque Concentrations

The following preparations exist, though their use in GFR measurement differs from CT imaging 1:

Concentration Iohexol (mg/mL) Typical CT Application
Omnipaque 350 755 Preferred for vascular imaging
Omnipaque 300 647 Standard for most CT applications
Omnipaque 240 518 Lower osmolality option

Important Safety Considerations

  • Renal function assessment is mandatory before contrast administration, as iohexol elimination half-life extends from ~2 hours (normal GFR) to 23-27 hours in severe renal impairment 4
  • Seven-day washout period is required if patient had prior iodinated contrast exposure 1
  • Hydration status matters, as volume contraction can affect contrast distribution and renal tolerance 1

Critical Pitfall

Do not use the 5 mL GFR measurement dose (3235 mg total iohexol) for diagnostic CT neck imaging 1—this dose is 20-30 times smaller than required for adequate vascular or soft tissue enhancement and will result in non-diagnostic images.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Iohexol Dilution Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Premedication for Gastrografin in Patients with Iohexol Allergy

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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