Identification
- Summary
Barium sulfate is a contrast agent used for CT scans of the gastrointestinal tract.
- Brand Names
- E-Z-HD, E-Z-Paque, Readi-cat 2
- Generic Name
- Barium sulfate
- DrugBank Accession Number
- DB11150
- Background
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
Structure for Barium sulfate (DB11150)
- Weight
- Average: 233.39
Monoisotopic: 233.856970451 - Chemical Formula
- BaO4S
- Synonyms
- Bario sulfato
- Barium sulfate
- 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.
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- Contraindications & Blackbox Warnings
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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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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.
- 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
Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.- Active Moieties
Name Kind UNII CAS InChI Key Barium unknown 24GP945V5T 7440-39-3 DSAJWYNOEDNPEQ-UHFFFAOYSA-N - Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Anatrast Paste 560 mg/1g Rectal Mallinckrodt 2009-06-01 2011-10-31 US 
Anatrast Pst 55% Paste 55 % Rectal Tyco Healthcare 1988-12-31 2010-01-07 Canada 
Baricon For suspension .98 g/1g Oral Mallinckrodt 2009-12-01 2011-04-30 US Baricon for Suspension Powder, for suspension 98 % Oral Tyco Healthcare 1988-12-31 2010-01-07 Canada Baro Bag Enema 98% Enema 98 % Rectal Tyco Healthcare 1984-12-31 2010-01-07 Canada Baro-cat Suspension 15 mg/1mL Oral; Rectal Mallinckrodt 2009-06-01 2011-03-31 US Barobag Enema Kit Powder, for suspension .97 g/1g Rectal Mallinckrodt 2009-06-01 2011-10-31 US Barobag Enema Kit Powder, for suspension .97 g/1g Rectal Mallinckrodt 2009-06-01 2011-10-31 US Barocat Susp 1.5% Suspension 1.5 % Oral; Rectal Tyco Healthcare 1988-12-31 2010-01-07 Canada Barosperse Powder, for suspension .95 g/1g Oral; Rectal Mallinckrodt 2009-12-01 2011-11-30 US - Over the Counter Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image BARYTGEN DE LUXE POWDER Powder 97.98 g/100g Oral EISAI (SINGAPORE) PTE. LTD. 1991-05-24 Not applicable Singapore Polibar Rapid 57% (p/p) Suspension 57 % Rectal Therapex Division De E Z Em Canada Inc 1989-12-31 2009-08-04 Canada - Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image E-Z HD SULFATODE BARIO PARA SUSPENSION Barium sulfate (88.6272 g) + Barium sulfate (9.8258 g) Powder, for suspension Oral AJOVECO S.A.S. 2007-06-07 Not applicable Colombia 
E-Z HD SULFATODE BARIO PARA SUSPENSION Barium sulfate (88.6272 g) + Barium sulfate (9.8258 g) Powder, for suspension Oral AJOVECO S.A.S. 2007-06-07 Not applicable Colombia - Unapproved/Other Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image Anatrast Barium sulfate (560 mg/1g) Paste Rectal Mallinckrodt 2009-06-01 2011-10-31 US Baricon Barium sulfate (.98 g/1g) For suspension Oral Mallinckrodt 2009-12-01 2011-04-30 US Baro-cat Barium sulfate (15 mg/1mL) Suspension Oral; Rectal Mallinckrodt 2009-06-01 2011-03-31 US Barobag Enema Kit Barium sulfate (.97 g/1g) Powder, for suspension Rectal Mallinckrodt 2009-06-01 2011-10-31 US Barobag Enema Kit Barium sulfate (.97 g/1g) Powder, for suspension Rectal Mallinckrodt 2009-06-01 2011-10-31 US Barosperse Barium sulfate (.95 g/1g) Powder, for suspension Oral; Rectal Mallinckrodt 2009-12-01 2011-11-30 US Barosperse Barium sulfate (.95 g/1g) Powder, for suspension Oral; Rectal Mallinckrodt 2009-12-01 2011-11-30 US Cheetah Barium sulfate (22 mg/1mL) Suspension Oral; Rectal Mallinckrodt 2009-12-01 2011-11-30 US E-Z-Cat Dry Barium sulfate (9.5 g/23g) Powder, for suspension Oral E-Z-EM Canada Inc 1996-01-01 2019-06-01 US E-Z-Disk Barium sulfate (700 mg/1) Tablet Oral E-Z-EM, INC. 2009-02-01 Not applicable US
Categories
- ATC Codes
- V08BA01 — Barium sulfate with suspending agents
- V08BA — Barium sulfate containing X-ray contrast media
- V08B — X-RAY CONTRAST MEDIA, NON-IODINATED
- V08 — CONTRAST MEDIA
- V — VARIOUS
- Drug Categories
- Barium Compounds
- Barium Sulfate Containing X-Ray Contrast Media
- Compounds used in a research, industrial, or household setting
- Contrast Media
- Diagnostic Uses of Chemicals
- Radiographic Contrast Agent
- Sulfates
- Sulfur Acids
- Sulfur Compounds
- Sulfuric Acids
- X-Ray Contrast Activity
- X-Ray Contrast Media, Non-Iodinated
- 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
- Affected organisms
- Humans
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+) sulfate
- SMILES
- [Ba++].[O-]S([O-])(=O)=O
References
- General References
- Williams SM, Harned RK: Recognition and prevention of barium enema complications. Curr Probl Diagn Radiol. 1991 Jul-Aug;20(4):123-51. [Article]
- 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. [Article]
- Barium Sulfate PubChem [Link]
- Barium Sulfate, Drugs.com [Link]
- NDA, Barium Sulfate [Link]
- FDA Approved Drug Products: E-Z-CAT DRY (barium sulfate) for oral suspension [Link]
- External Links
- PubChem Compound
- 24414
- PubChem Substance
- 347827920
- ChemSpider
- 22823
- 1331
- ChEBI
- 133326
- ChEMBL
- CHEMBL2105897
- Wikipedia
- Barium_sulfate
- FDA label
- Download (125 KB)
- MSDS
- Download (47.2 KB)
Clinical Trials
- Clinical Trials
Phase Status Purpose Conditions Count 4 Completed Diagnostic Patients With Potential Colorectal Neoplasia 1 Not Available Completed Not Available Aging / Deglutition / Healthy Swallowing 1 Not Available Completed Not Available Known or Suspected Abdominal Disease 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Powder, for suspension Rectal 96.4788 g Paste Rectal 560 mg/1g Paste Rectal 55 % Powder, for suspension Oral 98 % Powder, for solution Oral 10 g Suspension Oral 2 g Powder, for suspension Rectal 97.4 g Powder, for suspension Oral 98 g Powder Rectal 97.4 g Enema Rectal 98 % Suspension Oral; Rectal 15 mg/1mL Powder, for suspension Rectal .97 g/1g Suspension Oral; Rectal 1.5 % Powder, for suspension Oral; Rectal .95 g/1g Injection, powder, for solution Parenteral 97 g Enema Rectal 95 % Powder, for suspension Oral; Rectal 95 % Suspension 150 g/240ml Powder Oral 97.98 g/100g Suspension Oral; Rectal 2.2 % Suspension Oral; Rectal 22 mg/1mL Suspension Oral 4.9224 g Powder, for suspension Oral Powder, for suspension Oral; Rectal 96.3096 g Powder, for suspension Oral 400 mg/1g Powder, for suspension Oral 9.5 g/23g Tablet Oral 700 mg/1 Suspension Rectal 1.05 g/1mL Powder, for suspension Oral 980 mg/1g Powder, for suspension Oral 960 mg/1g Suspension Oral 0.6 g/1mL Powder, for solution Rectal 95 % Powder, for solution Oral; Rectal 95 % Cream Oral .6 g/1g Suspension 11.025 g Powder 340 g Powder, for solution Oral 82 % Suspension Oral 240 mg/1mL Powder, for suspension Oral 81 g Powder Oral 81 % Suspension Oral 500 mg/1mL Suspension Oral 50 % Suspension Oral 13 % Suspension Oral 130 mg/1mL Cream Oral 60 g / 100 g Paste Rectal 45 % Suspension Rectal 1000 mg/1mL Suspension Rectal 100 % For suspension Oral .98 g/1g For suspension Oral; Rectal .85 g/1mL Suspension Oral; Rectal 51 % Suspension Oral 98 % Paste Oral 440 mg/1g Paste Oral 44 % Suspension 400 g Suspension 5000 g Suspension Oral 2100 mg/1mL Suspension Oral 210 % Suspension Oral; Rectal 600 mg/1mL Suspension Oral; Rectal 60 % Suspension Oral; Rectal 1.05 g/1mL Liquid Oral 210 g / 100 mL Suspension Oral; Rectal 1000 mg/1mL Suspension Oral; Rectal 56 % Suspension Powder Suspension Oral; Rectal 1 g/ml Suspension Oral Powder, for suspension Rectal 965 mg/1g Suspension Rectal 57 % Powder 397 gr Suspension Oral; Rectal 150 mg/1mL Liquid Oral; Rectal 1.5 % Powder, for suspension Rectal Powder, for suspension Rectal 383.02 g Powder, for suspension Oral 98.45 G Powder, for suspension Oral Suspension 1 g/ml Suspension 960 ml Suspension 240 ml Suspension 240 g/240ml Suspension 150 ml Suspension Oral 13 mg/1mL Suspension Oral 20 mg/1mL Suspension Oral 21 mg/1mL Suspension Oral; Rectal 21 mg/1mL Suspension Oral; Rectal 11.07 g/225ml Suspension Oral 400 mg/1mL Suspension Oral; Rectal 5 % Suspension Oral; Rectal 50 mg/1mL For suspension Oral; Rectal .95 g/1g Powder Oral; Rectal 95 % Powder, for suspension Oral; Rectal 98 g/100g Powder, for suspension Oral; Rectal 96 g/100g Paste Oral 400 mg/1mL Powder, for suspension Oral .81 g/1g Powder, for suspension Rectal 960 mg/1g Powder, for suspension Oral; Rectal 980 mg/1g Suspension Oral 1 mg/1mL Powder, for suspension Oral 6 g/20ml - Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
Property Value Source melting point (°C) 1580 MSDS boiling point (°C) decomposes MSDS water solubility Very slightly soluble in cold water MSDS - Predicted Properties
Property Value Source logP -0.84 Chemaxon pKa (Strongest Acidic) -3 Chemaxon Physiological Charge -2 Chemaxon Hydrogen Acceptor Count 4 Chemaxon Hydrogen Donor Count 0 Chemaxon Polar Surface Area 80.26 Å2 Chemaxon Rotatable Bond Count 0 Chemaxon Refractivity 11.53 m3·mol-1 Chemaxon Polarizability 5.81 Å3 Chemaxon Number of Rings 0 Chemaxon Bioavailability 1 Chemaxon Rule of Five Yes Chemaxon Ghose Filter No Chemaxon Veber's Rule No Chemaxon MDDR-like Rule No Chemaxon - Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available
Drug created at December 03, 2015 16:51 / Updated at February 21, 2021 18:52