Gadoversetamide

Gadoversetamide Brand Name– Optimark

What is Gadoversetamide

Gadoversetamide is a gadolinium-based paramagnetic contrast agent used during diagnostic magnetic resonance imaging to enhance visualization of abnormal vascularity within the central nervous system (CNS) or liver and detect blood-brain barrier disruptions.

Approval was based on the results of 4 clinical trials (2 CNS and 2 hepatic). In all 4 trials, gadoversetamide MRI images (viewed in combination with non-contrast images) significantly improved lesion visualization as compared non-contrast images alone.

These results were based on the readers ability to delineate lesion boarders, identify the number of lesion, the readers confidence in number of lesions, as well as the level of conspicuity of all lesions.

Gadoversetamide, like all gadolinium-based contrast agents (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, with gadoversetamide being one of the agents associated with the most unconfounded cases.

Gadoversetamide was FDA-approved in December 1999

Indications

  • magnetic resonance imaging (MRI)

For use with magnetic resonance imaging (MRI) to enhance visualization of abnormal vascularity within the central nervous system (CNS) and liver and detect blood-brain barrier disruptions

Side Effects

  1. abdominal pain
  2. agitation
  3. anaphylactoid reactions
  4. anorexia
  5. anxiety
  6. arrhythmia exacerbation
  7. arthralgia
  8. asthenia
  9. back pain
  10. bronchospasm
  11. chest pain (unspecified)
  12. confusion
  13. constipation
  14. cough
  15. diarrhea
  16. diplopia
  17. dizziness
  18. drowsiness
  19. dysgeusia
  20. dyspepsia
  21. dysphagia
  22. dysphonia
  23. dyspnea
  24. edema
  25. eructation
  26. erythema multiforme
  27. fever
  28. headache
  29. hypercalcemia
  30. hyperhidrosis
  31. hypersalivation
  32. hypertension
  33. hypertonia
  34. hypotension
  35. injection site reaction
  36. laryngeal edema
  37. malaise
  38. muscle cramps
  39. myalgia
  40. nausea
  41. nephrogenic systemic fibrosis (nephrogenic fibrosing dermopathy)
  42. oliguria
  43. pallor
  44. palpitations
  45. paresthesias
  46. parosmia
  47. pelvic pain
  48. peripheral vasodilation
  49. pharyngitis
  50. phlebitis
  51. polydipsia
  52. pruritus
  53. rash
  54. renal failure (unspecified)
  55. rhinitis
  56. seizures
  57. sinus tachycardia
  58. sinusitis
  59. syncope
  60. tinnitus
  61. tremor
  62. urticaria
  63. vertigo
  64. vomiting
  65. xerostomia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • asthma
  • atopy
  • breast-feeding
  • diabetes mellitus
  • dialysis
  • extravasation
  • geriatric
  • hypertension
  • laboratory test interference
  • 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

  • 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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