Gadopentetate

Gadopentetate Brand Name– Magnevist

What is Gadopentetate

Gadopentetate dimeglumine for injection (Magnevist), a complex of gadolinium with a chelating agent, diethylenetriamine penta-acetic acid, is an ionic, paramagnetic contrast medium used to provide contrast enhancement during magnetic resonance imaging (MRI) of intracranial, spinal, head, neck, and body lesions with abnormal vascularity.

Although original indications encompassed spinal and cranial MRI only, in 1990 the indications for the use of gadopentetate dimeglumine were expanded to the demonstration or exclusion of lesions throughout the body.

Several other contrast agents are available in the US and other countries. Differences between the available agents include the chelating agent and physiochemical properties, such as osmolality, and whether or not the contrast is ionic.

When used at FDA-approved dosages and indications, differences between the contrast agents with regards to efficacy and safety are not apparent; however differences in safety could become apparent (due to physiochemical property differences) when gadopentetate is used at higher doses, faster injection rates, and for off-label indications.

Cases of nephrogenic systemic fibrosis (NSF) have prompted the FDA to request a boxed warning regarding the use of gadolinium-based contrast agents in those with renal insufficiency.

NSF has been reported with all currently marketed gadolinium-based contrast agents; however due to a variety of factors, the FDA is unable to determine which agents, if any, pose more risk.

The FDA approved gadopentetate dimeglumine in June 1988.

Indications

  • magnetic resonance imaging (MRI)

For use as contrast enhancement in magnetic resonance imaging (MRI) to visualize lesions with abnormal vascularity within the central nervous system (brain, spine, and associated tissues), head, neck, and body (excluding the heart)

Side Effects

  1. abdominal pain
  2. agitation
  3. anaphylactoid reactions
  4. angioedema
  5. anxiety
  6. arthralgia
  7. asthenia
  8. back pain
  9. bronchospasm
  10. cardiac arrest
  11. chills
  12. coma
  13. conjunctivitis
  14. cough
  15. cyanosis
  16. dental pain
  17. diarrhea
  18. diplopia
  19. dizziness
  20. drowsiness
  21. dysgeusia
  22. dyspnea
  23. erythema multiforme
  24. fatigue
  25. fever
  26. headache
  27. hyperhidrosis
  28. hypersalivation
  29. hypertension
  30. hypotension
  31. injection site reaction
  32. lacrimation
  33. laryngeal edema
  34. laryngospasm
  35. nausea
  36. nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)
  37. nystagmus
  38. ocular irritation
  39. ocular pain
  40. otalgia
  41. pallor
  42. paresthesias
  43. parosmia
  44. peripheral vasodilation
  45. phlebitis
  46. pruritus
  47. pulmonary edema
  48. rash
  49. renal failure (unspecified)
  50. respiratory arrest
  51. rhinitis
  52. seizures
  53. shivering
  54. sinus tachycardia
  55. skin necrosis
  56. sneezing
  57. syncope
  58. throat irritation
  59. thrombosis
  60. tissue necrosis
  61. tremor
  62. urinary incontinence
  63. urinary urgency
  64. urticaria
  65. vomiting
  66. xerostomia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

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

Interactions

There are no drug interactions associated with Gadopentetate products.

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