Iohexol

證據等級: L5

預測適應症: 2 個

Iohexol: From Diagnostic Radiocontrast Imaging to Insomnia

One-Sentence Summary

Iohexol is a non-ionic iodinated contrast agent used for diagnostic imaging procedures (myelography, angiography, CT) — it is not a therapeutic drug and has no established central nervous system activity. The TxGNN model predicts potential efficacy for Insomnia (score 99.87%) and, as a secondary candidate, Anxiety (score 99.25%), but no clinical trials or literature directly support either indication — the evidence pack itself flags the retrieved trial/literature hits as pharmacologically irrelevant noise rather than a genuine repurposing signal.

Quick Overview

Item	Content
Original Indication	Not applicable — Iohexol is a radiocontrast imaging agent, not a treated disease indication; no Taiwan license records exist to extract an approved indication text from
Predicted New Indication	Insomnia (disease)
TxGNN Prediction Score	99.87%
Evidence Level	L5 (model prediction only, no supporting studies)
Market Status (Taiwan)	未上市 (Not marketed)
Number of NDAs	0
Recommended Decision	Hold

Why is This Prediction Reasonable?

Currently, detailed mechanism of action data is not available (DrugBank MOA field is a data gap). Based on known pharmacology, Iohexol is a non-ionic iodinated contrast medium used purely for its radiopaque/osmotic properties in imaging procedures such as spinal myelography, angiography, and contrast-enhanced CT. It has no known central nervous system pharmacological activity and no established mechanistic link to sleep-regulation pathways (GABA, melatonin, orexin) or anxiolytic neurotransmission.

Because the original use of Iohexol is diagnostic rather than therapeutic, there is no plausible pharmacological bridge between its imaging role and either insomnia or anxiety treatment. The very high TxGNN scores (99.87% for insomnia, 99.25% for anxiety) most likely reflect graph co-occurrence artifacts — Iohexol frequently appears in clinical datasets alongside patients who separately report insomnia/anxiety symptoms (e.g., during pre-procedure workups, cancer/CKD monitoring, or as an incidental symptom in unrelated imaging studies) — rather than a real biological signal.

This assessment is reinforced by manual review of every retrieved trial and publication (below): none investigate Iohexol as a treatment for insomnia or anxiety.

Clinical Trial Evidence

Currently no related clinical trials registered.

Literature Evidence

Currently no related literature available.

Secondary Predicted Indication: Anxiety (Rank 2, Score 99.25%)

The evidence pack also returned 6 clinical trials and 6 publications for the “anxiety” candidate. On review, all are graded low relevance (Grade C) — none evaluate Iohexol as an anxiety treatment; Iohexol appears only incidentally as a contrast/GFR-marker agent in unrelated studies (renal function, transplant, cardiovascular monitoring), or “anxiety” appears as an incidental symptom description in imaging-procedure papers.

Clinical Trials

Trial Number	Phase	Status	Enrollment	Key Findings
NCT01053130	N/A	Completed	16	Weight-loss surgery effect on CKD progression — not relevant, Iohexol likely used only as a GFR clearance marker
NCT01629537	Phase 2	Completed	41	Stellate ganglion block for PTSD — Iohexol not the study drug; relates to imaging guidance only
NCT02864706	Phase 4	Completed	95	Long-term follow-up of everolimus after heart transplant — unrelated to anxiety treatment
NCT03736005	N/A	Completed	40	Muscle wasting/renal dysfunction after critical illness — Iohexol used as a kidney-function measurement tool
NCT05428631	N/A	Recruiting	10	CardioMEMS hemodynamic monitoring device tolerability study — unrelated to anxiety
NCT00634920	Phase 4	Completed	204	Everolimus vs. cyclosporine conversion in renal transplant recipients — unrelated to anxiety

Literature

PMID	Year	Type	Journal	Key Findings
8883531	1996	RCT	Academic Radiology	Double-blind comparison of iodixanol vs. iohexol in extremity phlebography — safety/tolerability of imaging, not anxiety treatment
2352635	1990	Cohort	Neuroradiology	Side effects of lumbar iohexol myelography; “anxiety/depression” listed as a minor post-procedure side effect, not a treated outcome
2125805	1990	Cohort	Acta Neurochirurgica	Doppler monitoring during cerebral angiography — no anxiety treatment relevance
39861464	2025	Review	Nutrients	Physical activity and nutrition in onco-nephrology; anxiety mentioned only as a general PA-benefit outcome, unrelated to Iohexol
16034655	2005	Cohort	Cardiovascular and Interventional Radiology	Caval filter placement via arm access in elderly; “patient anxiety” cited as a reason for alternate access site, not an Iohexol indication
25690708	2015	Cohort	La Radiologia Medica	CT hiatal hernia over-reporting causing patient anxiety — incidental mention, unrelated to treatment

US Market Information

Iohexol is not currently marketed in Taiwan — 0 license records are on file (total_licenses: 0), so no NDA/product table can be generated.

Safety Considerations

Please refer to the package insert for safety information.

(Note: TFDA label warnings/contraindications are flagged as a Blocking data gap (DG001) — this prevents any formal S1 safety pre-screening for either candidate indication.)

Conclusion and Next Steps

Decision: Hold

Rationale: Both candidate indications (insomnia and anxiety) score L5 — model prediction only, with zero supporting clinical trials or literature after relevance review. Iohexol’s known pharmacology (radiocontrast agent, no CNS activity) offers no mechanistic rationale for either use, and the retrieved evidence is assessed as knowledge-graph noise rather than a real signal.

To proceed, the following is needed:

MOA data from DrugBank API (High-severity data gap, DG002)
TFDA label warnings/contraindications (Blocking data gap, DG001) — required before any S1 safety pre-screening
A genuine mechanistic hypothesis connecting Iohexol to CNS/sleep or anxiety pathways before further evidence collection is warranted
If pursued despite the above, targeted literature search specifically for “iohexol AND (insomnia OR anxiety) AND treatment” (current searches returned no on-topic results)
Disclaimer

This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.