Mechanism of effect
Paramagnetic agent; exposure to external magnetic field in gadopentetate may induce a large magnetic field. The local magnetism may change proton density and spin characteristics, which it is then detected by the imaging device
Pharmacokinetics
Excretion: urine (90-100%)
Dialyzable: yes
Vd: 266 mL/kg; does not cross intact brain barrier
Half-life: 1.6 hr
Excretion: Urine (91%)
Dosage
It has injectable solution 469.01mg/mL
MRI contrast agent dose 0.2 mL/kg IV bolus; not to exceed infusion rate of 10 mL/15 seconds
Dosing in patients > 286 pounds not studiedAlerts
Black Box Warnings
Risk for nephrogenic systemic fibrosis (NSF) with acute or chronic renal insufficiency (GFR <30 mL/min/1.73 m²), hepatorenal syndrome, or acute renal insufficiency resulting from perioperative liver transplant
NSF affects internal organs, skin, and muscle and can be fatal
Only use if essential and MRI cannot not provide appropriate diagnostic image
Screen for renal dysfunction, not to exceed recommended dosage, and allow for drug elimination before giving subsequent doses
Warnings
Screen all patients for renal dysfunction
Thrombotic syndromes, anemia, hepatic/renal impairment, hemoglobinopathies (sickle cell anemia)
Risk for nephrogenic systemic fibrosis (NSF) in patients w/acute or chronic severe renal insufficiency, hepatorenal syndrome or in perioperative liver transplantation period (see Black Box Warnings)
Risk of hypotension
Site of injection may develop thrombosis
History of grand mal seizure
Safety of repeat doses not studied
Brain deposits
7/28/2015: FDA is investigating the risk of brain deposits following repeated use of gadolinium-based contrast agents (GBCAs) for MRI
Recent publications in the medical literature have reported that deposits of GBCAs remain in the brains of some patients who undergo ≥4 contrast MRI scans, long after the last administration
It is unknown whether these gadolinium deposits are harmful or can lead to adverse health effects
Early data in rat studies show that linear GBCAs are more prone to dissociation into free gadolinium and demonstrate greater brain deposition than macrocyclic GBCAs, which are less prone to dissociation
Points of recommendation
Tell all of your health care providers that you take this medicine. This includes your doctors, nurses, pharmacists, and dentists.
Very bad and sometimes deadly allergic reactions have rarely happened. Talk with your doctor.
Kidney failure has happened with gadopentetate dimeglumine in people who already had kidney problems. Talk with the doctor.
Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pre gnant.
Some side effects that you need tell your doctor:
Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
This medicine may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your body.
Ask a Pharmacist