Gadobutrol

Gadobutrol Brand Name– Gadavist

What is Gadobutrol

Gadobutrol is a paramagnetic, gadolinium-based contrast agent (GBCA) indicated for use during magnetic resonance imaging (MRI) to assess myocardial perfusion in patients with known or suspected coronary artery disease, assess the presence and extent of malignant breast disease, and detect and visualize areas with disrupted blood-brain barrier and/or abnormal vascularity within the central nervous system (CNS).

It is also used in magnetic resonance angiography (MRA) to evaluate known or suspected supra-aortic or renal artery disease.

Gadobutrol, like all GBCAs, carries a black box warning for nephrogenic systemic fibrosis (NSF).

NSF is a serious condition that may result in fatal or debilitating fibrosis of the skin, muscle, and internal organs.

The propensity to cause NSF differs among available GBCAs; few, if any, confirmed cases have been associated with gadobutrol while most unconfounded cases have been reported with gadodiamide, gadopentetate dimeglumine, and gadoversetamide.

Indications

  • angiography
  • magnetic resonance imaging (MRI)

For use with magnetic resonance imaging (MRI) to assess myocardial perfusion in patients with known or suspected coronary artery disease, assess the presence and extent of malignant breast disease, and detect and visualize areas with disrupted blood-brain barrier and/or abnormal vascularity within the central nervous system (CNS)

Side Effects

  1. anaphylactic shock
  2. anaphylactoid reactions
  3. angioedema
  4. bronchospasm
  5. cardiac arrest
  6. chest pain (unspecified)
  7. conjunctivitis
  8. cough
  9. cyanosis
  10. dizziness
  11. dysgeusia
  12. dyspnea
  13. erythema
  14. headache
  15. hyperhidrosis
  16. hypertension
  17. injection site reaction
  18. laryngeal edema
  19. maculopapular rash
  20. malaise
  21. nausea
  22. nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)
  23. pallor
  24. palpitations
  25. paresthesias
  26. parosmia
  27. pruritus
  28. pulmonary edema
  29. rash
  30. renal failure (unspecified)
  31. respiratory arrest
  32. sinus tachycardia
  33. sneezing
  34. urticaria
  35. vomiting
  36. xerostomia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • aortic stenosis
  • asthma
  • atopy
  • breast-feeding
  • diabetes mellitus
  • dialysis
  • extravasation
  • geriatric
  • hypertension
  • magnetic resonance imaging (MRI)
  • nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)
  • pregnancy
  • radiopaque contrast media hypersensitivity
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • sickle cell disease

Interactions

  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir alafenamide
  • Tenofovir Alafenamide
  • Tenofovir Alafenamide
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