INDICATIONS
Sinografin (Diatrizoate Meglumine and lodipamide Meglumine Injection) is indicated for use in
hysterosalpingography.
DOSAGE AND ADMINISTRATION
As a convenience to the physician, the following guidelines which have proven satisfactory are
provided (see PRECAUTIONS, General). Patients should be counseled prior to radiographic
examination (see PATIENT INFORMATION).
Preparation Of The Patient
Hysterosalpingography should be performed three to five days after the
cessation of the patient’s menstrual period as a precautionary measure. An enema and vaginal douche
one hour before the examination are helpful, but not essential. The patient should empty her bladder
before the examination. Since the procedure is remarkably free of pain when Sinografin (Diatrizoate
Meglumine and lodipamide Meglumine Injection) is used, the use of a narcotic or anesthesia is
unnecessary.
Dosage
3 to 4 mL of Sinografin, administered in fractional doses of approximately 1 mL, are usually
adequate to visualize the uterus; an additional 3 to 4 mL will demonstrate the tubes. Total doses varying
from 1.5 to 10 mL have been employed with satisfactory results.
Administration
The patient is placed in the lithotomy position and the vulva is cleansed with a suitable
antiseptic solution. A Graves-type vaginal speculum is introduced, the cervix is exposed, and the
vaginal vault is sponged with antiseptic solution.
A tenaculum is placed on the cervical lip, usually the anterior lip. A sterile sound may be passed to
determine the position of the uterus and the direction of the cervical canal, and, when necessary, the
cervical canal may be dilated. (Sounding the uterine cavity and dilatation of the canal are not usually
required when a flexible cannula tip is used.)
A sterile syringe containing the Sinografin is attached by Luer-Lok to a uterine cannula. The two-way
cannula valve is opened and all air bubbles in the cannula and syringe are expressed. About 1.5 to 2 mL
of Sinografin (Diatrizoate Meglumine and lodipamide Meglumine Injection) are required to fill the
cannula. (If preferred, a tubal insufflator under controlled pressure with a salpingogram attachment may
be used instead of the syringe.)
The cannula tip is inserted into the cervical canal so that the adjustable rubber acorn obturator fits
snugly at the external os. Careful placement of the cannula is important to avoid trauma and pain.
Squeezing the trigger of the cannula to provide simultaneous traction on the tenaculum and forward
pressure on the cannula should give a nonleaking cervical seal. Sinografin flows freely so that only
gentle pressure on the plunger is necessary; however, the medium should be used as promptly as
possible following withdrawal into the syringe. The syringe should be rinsed as soon after the
procedure as possible to prevent freezing of the plunger.
The connection at the external os is checked for leakage. If the acorn obturator is inadequate, an
inflatable balloon-obturator may be used to seal the cervical canal. When the equipment has been
positioned satisfactorily, the tenaculum and cannula may be fixed in position until the procedure is
terminated.
Radiography
A scout film may be made before the medium is administered. After the initial fractional
injection, a film should be made using a Bucky diaphragm. After each successive injection of 1 mL, a
film is taken, developed immediately, and inspected in the dark room before the next fractional dose of
Sinografin (Diatrizoate Meglumine and lodipamide Meglumine Injection) is given, until the procedure is
completed. Further injection and subsequent films can be made as required using posterior-anterior or
oblique angles.
Clinical experience indicates that tubal patency, if present, will be demonstrable at the time of the
injection and delayed films have not been required.
General
Diatrizoate Meglumine and lodipamide Meglumine Injection should be inspected visually for particulate
matter and discoloration prior to instillation whenever solution and container permit. The solution may
vary in color from essentially colorless to pale yellow. Solutions which may have become substantially
darker should not be used.
In the event that crystallization occurs, the solution may be clarified by placing the vial in hot water and
shaking gently for several minutes or until the solution is clear. If cloudiness persists, the preparation
should not be used. Allow the solution to cool to body temperature before administering.
HOW SUPPLIED
Sinografin (Diatrizoate Meglumine And Lodipamide Meglumine Injection)
Packages of ten single-dose 10 mL vials (NDC 0270-0523-30).
Storage
Store at 20-25°C (68-77°F) [See USP]. Protect from light.
Manufactured by: Patheon Italia S.p.A. 03013 Ferentino (Italy). Revised: Oct 2013