Gadoterate meglumine

Gadoterate meglumine Brand Name– Dotarem

What is Gadoterate meglumine

Gadoterate meglumine is a macrocyclic ionic paramagnetic contrast agent indicated for use during magnetic resonance imaging (MRI) of the brain, spine, and associated tissues in adults and pediatric patients (including neonates).

When administered prior to imaging, gadoterate meglumine provides enhanced visualization and detection of areas with disruptions in the blood brain barrier or abnormal vascularity.

Nephrogenic systemic fibrosis (NSF) may develop after use of gadoterate meglumine, and other gadolinium-based contrast agents (GBCAs), in patients with impaired elimination of the drugs.

GBCA-induced NSF may result in fatal or debilitating fibrosis affecting the skin, muscle, and internal organs.

Patients at highest risk include those with acute renal injury and chronic, severe renal impairment (glomerular filtration rate less than 30 mL/minute/1.73 m²); a black boxed warning has been issued regarding use of these agents in patients with renal insufficiency.

Indications

• magnetic resonance imaging (MRI)

For use as a contrast enhancement in magnetic resonance imaging (MRI) to detect and visualize areas of the brain, spine, and associated tissues with disruption of the blood brain barrier and/or abnormal vascularity

Side Effects

1. anaphylactoid reactions
2. angioedema
3. anxiety
4. arrhythmia exacerbation
5. asthenia
6. blepharitis
7. bradycardia
8. bronchospasm
9. cardiac arrest
10. coma
11. conjunctivitis
12. cyanosis
13. diarrhea
14. dizziness
15. drowsiness
16. dysgeusia
17. fatigue
18. fever
19. headache
20. hyperhidrosis
21. hypersalivation
22. hypertension
23. hypotension
24. injection site reaction
25. lacrimation
26. laryngospasm
27. malaise
28. nausea
29. nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)
30. palpitations
31. paresthesias
32. parosmia
33. pruritus
34. rash
35. renal failure (unspecified)
36. respiratory arrest
37. seizures
38. sinus tachycardia
39. syncope
40. tremor
41. urticaria
42. vomiting
43. weakness

Monitoring Parameters

• serum creatinine/BUN

Contraindications

• 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 disease
• renal failure
• renal impairment
• sickle cell disease

Interactions

• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acyclovir
• Aldesleukin, IL-2
• Alogliptin; Metformin
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Canagliflozin; Metformin
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Codeine; Phenylephrine; Promethazine
• Dapagliflozin; Metformin
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dopamine
• Droxidopa
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enflurane
• Ephedrine
• Ertugliflozin; Metformin
• Ethanol
• Etomidate
• Fospropofol
• General anesthetics
• Glipizide; Metformin
• Glyburide; Metformin
• Guaifenesin; Phenylephrine
• Halothane
• Hydrocodone; Phenylephrine
• Isoflurane
• Ketamine
• Linagliptin; Metformin
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Midodrine
• Nonsteroidal antiinflammatory drugs
• Norepinephrine
• Oxaliplatin
• Phenylephrine
• Phenylephrine; Promethazine
• Propofol
• Sevoflurane
• Sodium Iodide
• Valacyclovir
• Vasopressors