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
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