Barium sulfate

Identification

Name
Barium sulfate
Accession Number
DB11150
Description

Barium sulfate is an inorganic compound with the chemical formula BaSO4 3.

Barium sulfate occurs in nature as the mineral barite. It is also used in various manufacturing applications and mixed into heavy concrete to serve as a radiation shield 3.

This drug is used as a contrast agent in diagnostic x-ray procedures. Therapeutic advantages of barium sulfate in diagnostic procedures include both its low water solubility and high level of clearance from the body Label.

Barium sulfate is ingested by mouth or administered rectally and combined with granules of effervescent bicarbonate to enhance distension of the GI tract, allowing for enhanced gastrointestinal tract visualization 3, 5.

Type
Small Molecule
Groups
Approved
Structure
Thumb
Weight
Average: 233.39
Monoisotopic: 233.856970451
Chemical Formula
BaO4S
Synonyms
  • Bario sulfato
External IDs
  • CI 77120

Pharmacology

Indication

Barium sulfate is a radiographic contrast agent indicated for use in computed tomography (CT) of the abdomen to delineate the gastrointestinal (GI) tract in adult and pediatric patients Label.

Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Barium sulfate increases the absorption of x-rays as they are passed throughout the body, delineating body structures, in which barium sulfate is localized. This allows for the clear visualization of normal organs/defect in normal anatomy 5.

Mechanism of action

Barium sulfate is a heavy metal with a high atomic number (Z=56) and a K shell binding energy (K-edge of 37.4 keV) very close to that of most diagnostic x-ray beams. Due to these characteristics, barium is an ideal medium for the absorption of x-rays Label.

Barium sulfate is essentially not absorbed from the GI tract nor metabolized in the body. Barium sulfate is used to fill the gastrointestinal tract lumen or to coat the mucosal surface and is administered orally, rectally, or instilled into an enterostomy tube or catheter Label, 5.

Barium sulfate enhances delineation of the GI tract. The barium suspension covers the mucosal surface of the GI tract, allowing its shape, distensibility, motion, integrity, continuity, location within the torso, relationship to other organs to be closely examined 5. Various abnormalities, such as benign or malignant tumors, ulcers, strictures, diverticula, inflammation or infection, altered motility, displacement and other pathology can thereby be identified Label, 5.

At lower concentrations (higher dilution), barium enhances the conspicuity of the GI tract to differentiate the GI tract from various abdominal organs in computed tomography examinations (CT scans) of the abdomen. Improved delineation of the gastrointestinal tract lumen and mucosa may be reached by contrast provided by gas (by the addition of bicarbonate or gas-filled balloons) in addition to the barium 5. This is known as a double-contrast procedure. Osmotically active agents (for example, sorbitol) are also used to induce fluid accumulation and distension of the GI system to enhance visualization 5.

Absorption

Barium sulfate is not absorbed following oral or rectal administration with a normal gastrointestinal tract. In patients with a normal GI tract, barium sulfate is normally excreted within 24 hr after oral ingestion. Post rectal administration of barium sulfate suspensions, the drug is generally excreted when the enema is released. Some barium may remain in the colon for several weeks, however, and eventually clears, especially in patients with impaired intestinal peristalsis 3. It is difficult to quantify the uptake of ingested barium because of a number of factors affect its absorption. The presence of sulfate in food can cause the precipitation of barium sulfate 3.

The following is the approximate time to peak opacification of organs by barium sulfate in a healthy GI tract:

Esophagus, stomach, and duodenum uptake of barium sulfate occurs almost immediately after oral administration 4.

Small intestine uptake is dependent on gastric emptying rate and viscosity of the preparation; it may be delayed 15-90 minutes post ingestion 4.

Small intestine (enteroclysis studies) uptake is immediate, following direct instillation 4.

Colon and distal small intestine uptake are dependent on patient positioning. Hydrostatic pressure also determines the rate and degree of opacification 4.

Volume of distribution
Not Available
Protein binding
Not Available
Metabolism

Barium sulfate is poorly water soluble and shows negligible levels of absorption from the gastrointestinal tract following both oral or rectal administration. In healthy subjects, orally administered barium sulfate is generally excreted within 24 hours. Rectally administered barium sulfate is eliminated with clearance of the enema 5.

Route of elimination

Barium sulfate is excreted unchanged in the feces 3.

Half-life
Not Available
Clearance

The rate of excretion of barium sulfate is dependent on the route of administration and the status of peristaltic activity and motility of the gastrointestinal tract 5.

Adverse Effects
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Toxicity

Acute Exposure

Nausea, vomiting, diarrhea and abdominal cramping may occur Label. Acute exposure to barium sulfate may irritate the eyes and respiratory tract. Exposure to inhalation or other forms can affect the nervous system and lead to hypokalemia, which can contribute to cardiovascular rhythm abnormality 3. Hypersensitivity, gastrointestinal transit delay, obstruction, aspiration pneumonitis and systemic embolization of barium sulfate are more serious complications of administration Label. In addition, fatalities have occurred due to aspiration pneumonitis, barium sulfate impaction, intestinal perforation with subsequent peritonitis and granuloma formation, and vasovagal and syncopal episodes Label, 2.

*Chronic Exposure *

The lungs may be affected by repeated or prolonged exposure to dust particles, resulting in baritosis (a type of benign pneumoconiosis) 3. Inhalation of barium sulfate dust may lead to a benign pneumoconiosis ("baritosis") with conspicuous radiographic characteristics but no signs of impairment of pulmonary function 3.

Intra-abdominal leakage

Intra-abdominal leakage may occur during or after administration of barium sulfate Label,5. Caution is advised in patients with a history of food aspiration and in patients with diagnosed swallowing disorders Label.

** A note on GI perforation**

Perforation of the colon after rectal administration of barium sulfate suspension has been reported due to the increased hydrostatic pressure of the instilled suspension, trauma to the colon from an enema tip, or forceful or deep insertion of a non-flexible enema tip. Perforation of the bowel has been followed by peritonitis, adhesions, granulomas, and death 4. This is a rare occurrence. Injury to the rectal mucosa or anal canal due to the enema tip or retention balloon is likely the most common traumatic cause of perforation during treatment. Inflation of a balloon within a stricture, neoplasm, inflamed rectum, or stoma is hazardous, and caution should be exerted 1.

Carcinogenicity and mutagenicity

No animal studies have been performed to evaluate the carcinogenicity of barium sulfate or potential effects on reproduction Label. Elective contrast radiography of the abdomen is not routintely recommended during pregnancy because of the risks to the fetus from radiation exposure 4.

Affected organisms
  • Humans
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Not Available
Food Interactions
No interactions found.

Products

Active Moieties
NameKindUNIICASInChI Key
Bariumunknown24GP945V5T7440-39-3DSAJWYNOEDNPEQ-UHFFFAOYSA-N
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
AnatrastPaste560 mg/1gRectalMallinckrodt2009-06-012011-10-31US flag
Anatrast Pst 55%PasteRectalTyco Healthcare1988-12-312010-01-07Canada flag
BariconFor suspension.98 g/1gOralMallinckrodt2009-12-012011-04-30US flag
Baricon for SuspensionPowder, for suspensionOralTyco Healthcare1988-12-312010-01-07Canada flag
Baro Bag Enema 98%EnemaRectalTyco Healthcare1984-12-312010-01-07Canada flag
Baro-catSuspension15 mg/1mLOral; RectalMallinckrodt2009-06-012011-03-31US flag
Barobag Enema KitPowder, for suspension.97 g/1gRectalMallinckrodt2009-06-012011-10-31US flag
Barobag Enema KitPowder, for suspension.97 g/1gRectalMallinckrodt2009-06-012011-10-31US flag
Barocat Susp 1.5%SuspensionOral; RectalTyco Healthcare1988-12-312010-01-07Canada flag
BarospersePowder, for suspension.95 g/1gOral; RectalMallinckrodt2009-12-012011-11-30US flag
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Polibar Rapid 57% (p/p)SuspensionRectalTherapex Division De E Z Em Canada Inc1989-12-312009-08-04Canada flag
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more
  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

    Learn more
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
AnatrastBarium sulfate (560 mg/1g)PasteRectalMallinckrodt2009-06-012011-10-31US flag
BariconBarium sulfate (.98 g/1g)For suspensionOralMallinckrodt2009-12-012011-04-30US flag
Baro-catBarium sulfate (15 mg/1mL)SuspensionOral; RectalMallinckrodt2009-06-012011-03-31US flag
Barobag Enema KitBarium sulfate (.97 g/1g)Powder, for suspensionRectalMallinckrodt2009-06-012011-10-31US flag
Barobag Enema KitBarium sulfate (.97 g/1g)Powder, for suspensionRectalMallinckrodt2009-06-012011-10-31US flag
BarosperseBarium sulfate (.95 g/1g)Powder, for suspensionOral; RectalMallinckrodt2009-12-012011-11-30US flag
BarosperseBarium sulfate (.95 g/1g)Powder, for suspensionOral; RectalMallinckrodt2009-12-012011-11-30US flag
CheetahBarium sulfate (22 mg/1mL)SuspensionOral; RectalMallinckrodt2009-12-012011-11-30US flag
E-Z-Cat DryBarium sulfate (9.5 g/23g)Powder, for suspensionOralE-Z-EM Canada Inc1996-01-012019-06-01US flag
E-Z-DiskBarium sulfate (700 mg/1)TabletOralE-Z-EM, INC.2009-02-01Not applicableUS flag

Categories

ATC Codes
V08BA02 — Barium sulfate without suspending agents
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of inorganic compounds known as alkaline earth metal sulfates. These are inorganic compounds in which the largest oxoanion is sulfate, and in which the heaviest atom not in an oxoanion is an alkaline earth metal.
Kingdom
Inorganic compounds
Super Class
Mixed metal/non-metal compounds
Class
Alkaline earth metal oxoanionic compounds
Sub Class
Alkaline earth metal sulfates
Direct Parent
Alkaline earth metal sulfates
Alternative Parents
Inorganic salts / Inorganic oxides
Substituents
Alkaline earth metal sulfate / Inorganic oxide / Inorganic salt
Molecular Framework
Not Available
External Descriptors
Not Available

Chemical Identifiers

UNII
25BB7EKE2E
CAS number
7727-43-7
InChI Key
TZCXTZWJZNENPQ-UHFFFAOYSA-L
InChI
InChI=1S/Ba.H2O4S/c;1-5(2,3)4/h;(H2,1,2,3,4)/q+2;/p-2
IUPAC Name
barium(2+) ion sulfate
SMILES
[Ba++].[O-]S([O-])(=O)=O

References

General References
  1. Williams SM, Harned RK: Recognition and prevention of barium enema complications. Curr Probl Diagn Radiol. 1991 Jul-Aug;20(4):123-51. [PubMed:1889235]
  2. Hoevels J, Thermann M: [Barium sulfate and water-soluble contrast medium--a suitable mixture for contrast radiography in acute small bowel obstruction]. Zentralbl Chir. 2003 Jun;128(6):500-5. doi: 10.1055/s-2003-40624. [PubMed:12865956]
  3. Barium Sulfate PubChem [Link]
  4. Barium Sulfate, Drugs.com [Link]
  5. NDA, Barium Sulfate [Link]
  6. FDA Approved Drug Products: E-Z-CAT DRY (barium sulfate) for oral suspension [Link]
PubChem Compound
24414
PubChem Substance
347827920
ChemSpider
22823
RxNav
1331
ChEBI
133326
ChEMBL
CHEMBL2105897
Wikipedia
Barium_sulfate
FDA label
Download (125 KB)
MSDS
Download (47.2 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedDiagnosticPatients With Potential Colorectal Neoplasia1
Not AvailableCompletedNot AvailableKnown or Suspected Abdominal Disease1
Not AvailableEnrolling by InvitationBasic ScienceAging / Deglutition / Healthy Swallowing1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
PowderRectal96.4788 g
PasteRectal560 mg/1g
Powder, for suspensionOral
Powder, for solutionOral10 g
PowderRectal97.4 g
Powder, for suspensionOral98 g
Powder, for suspensionOral30 g/100mL
SuspensionOral; Rectal15 mg/1mL
Powder, for suspensionRectal.97 g/1g
Powder, for suspensionOral; Rectal.95 g/1g
EnemaRectal
Powder, for suspensionOral; Rectal
Powder, for solutionOral97.98 g/100g
SuspensionOral; Rectal2.2 %
SuspensionOral; Rectal22 mg/1mL
SuspensionOral30 g/100mL
SuspensionOral4.9224 g
Powder, for suspensionOral88.6272 g
Powder, for suspensionOral; Rectal96.3096 g
Powder, for suspensionOral400 mg/1g
Powder, for suspensionOral9.5 g/23g
TabletOral700 mg/1
SuspensionRectal1.05 g/1mL
Powder, for suspensionOral980 mg/1g
Powder, for suspensionOral960 mg/1g
SuspensionOral0.6 g/1mL
Powder, for solutionRectal
Powder, for solutionOral; Rectal
CreamOral.6 g/1g
Suspension11.025 g
Powder340 g
Powder, for solutionOral82 %
SuspensionOral240 mg/1mL
PowderOral
SuspensionOral500 mg/1mL
SuspensionOral13 %
SuspensionOral130 mg/1mL
CreamOral
PasteRectal
SuspensionRectal1000 mg/1mL
For suspensionOral.98 g/1g
For suspensionOral; Rectal.85 g/1mL
PasteOral440 mg/1g
PasteOral
Suspension400 g
Suspension5000 g
SuspensionOral2100 mg/1mL
SuspensionOral
SuspensionOral; Rectal600 mg/1mL
SuspensionOral; Rectal
SuspensionOral; Rectal1.05 g/1mL
LiquidOral
SuspensionOral; Rectal1000 mg/1mL
Suspension
Powder, for solutionRectal92 g/100g
Powder
Powder, for suspensionOral95 g/100g
Powder, for suspensionOral92 g/100g
SuspensionOral50 mg/ml
Powder160 g
Powder, for suspensionRectal965 mg/1g
SuspensionRectal
Powder397 gr
SuspensionOral; Rectal150 mg/1mL
LiquidOral; Rectal
Powder, for suspensionOral98.45 G
Powder, for suspensionOral334.74 g
Suspension960 ml
Suspension240 ml
Suspension150 g/240ml
Suspension240 g/240ml
Suspension150 ml
SuspensionOral13 mg/1mL
SuspensionOral20 mg/1mL
SuspensionOral21 mg/1mL
SuspensionOral; Rectal21 mg/1mL
SuspensionOral; Rectal140 g/100mL
SuspensionOral400 mg/1mL
SuspensionOral; Rectal50 mg/1mL
For suspensionOral; Rectal.95 g/1g
PowderOral; Rectal
Powder, for suspensionOral; Rectal98 g/100g
Powder, for suspensionOral; Rectal96 g/100g
PasteOral400 mg/1mL
Powder, for suspensionOral.81 g/1g
Powder, for suspensionRectal960 mg/1g
Powder, for suspensionOral; Rectal980 mg/1g
SuspensionOral1 mg/1mL
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)1580MSDS
boiling point (°C)decomposesMSDS
water solubilityVery slightly soluble in cold waterMSDS
Predicted Properties
PropertyValueSource
logP-0.84ChemAxon
pKa (Strongest Acidic)-3ChemAxon
Physiological Charge-2ChemAxon
Hydrogen Acceptor Count4ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area80.26 Å2ChemAxon
Rotatable Bond Count0ChemAxon
Refractivity11.53 m3·mol-1ChemAxon
Polarizability5.81 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available

Drug created on December 03, 2015 09:51 / Updated on June 12, 2020 11:42

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