Among 781 cases of adverse drug reactions reported in 2010 to the Medicines and medical devices agency of Serbia involving 546 suspected drugs, the greatest reporting frequency was found for contrast media used in radiological diagnosis and visualization. Most of the commercial contrast media may be classified to inorganic (barium sulfate) and organic (iodine contrast media – ionizing and non-ionizing, low-osmolar, high-osmolar and isoosmolar). Iso-osmolar and low-osmolar contrast media are the most frequently used at domestic market, mainly because of the most favorable safety profile and tolerability. As their alternative in patients with hypersensitivity reactions to the iodine contrast media, gadoliniumcontaining contrast agents can be administered. Overall the incidence of adverse effects is 5-15%, while the incidence of serious adverse reactions is 0.04 to 0.14%. By mechanism and predictability, adverse reactions are classified to idiosyncratic and non-idiosyncratic. In clinical practice, the most common adverse reactions are mild - extravasation, headache, limb oedema, nausea, vomiting, bronchospasm, bradycardia, etc. However, serious side effects are the most significant; though rare, these can be dangerous, such as nephropathy, anaphylactic shock, thrombosis, arrhythmias, angina attacks and myocardial infarction, serious thrombocytopenia, neurological episodes with subsequent permanent sequelae and/or fatal outcome. Special attention is devoted to the systematization of available contrast media, the classification of adverse reactions and measures for their prevention in individuals with risk factors identified from the available primary evidence of high methodological quality and clinical validity.

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