Adult Dosing
Used in MRI of brain (intracranial), spine and associated tissues in adult and pediatric patients (2 years of age and older) to detect and visualize areas with disruption of the blood brain barrier (BBB) and/or abnormal vascularity
- 0.1 mmol/kg (0.2 mL/kg) body weight administered as an IV bolus injection infused at rate of 2 mL/second
Pediatric Dosing
Used in MRI of brain (intracranial), spine and associated tissues in adult and pediatric patients (2 years of age and older) to detect and visualize areas with disruption of the blood brain barrier (BBB) and/or abnormal vascularity
- (Child: >2 years old): 0.1 mmol/kg (0.2 mL/kg) body weight administered as an IV bolus injection infused at rate of 1-2 mL/second
- (Child: <2 years old): Safety and efficacy have not been established
[Outline]
- Gadolinium based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (GFR < 30 mL/min/1.73m2), or acute renal insufficiency due to the hepato-renal syndrome or in the perioperative liver transplantation period. Avoid use of GBCAs among these patients unless the diagnostic information is essential and not available with non-contrast MRI or other modalities. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle, and internal organs [US black box warning]
- Avoid use in such patients unless the diagnostic information is essential and not available with non-contrast enhanced MRI [US black box warning]
- Screen all patients for renal dysfunction or acute kidney injury. Do not exceed the recommended dose and allow a sufficient period of time for elimination of the agent from the body prior to any re-administration [US black box warning]
- For patients at risk for chronically reduced renal function (for example, age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing [US black box warning]
- For patients receiving hemodialysis, the prompt initiation of hemodialysis following the administration of a GBCA in order to enhance the contrast agent’s elimination may be considered
- Anaphylactic and anaphylactoid reactions including cardiovascular, respiratory, and/or cutaneous manifestations, circulatory collapse and death have been reported with therapy
- Before initiating therapy, assess all patients for any history of a reaction to contrast media, bronchial asthma and/or allergic disorders. These patients may have an increased risk for a hypersensitivity reaction
- Administer only in situations where trained personnel and therapies are promptly available for the treatment of hypersensitivity reactions, including personnel trained in resuscitation
- Closely monitor patients for signs and symptoms of hypersensitivity reactions throughout the therapy
- Use of GBCAs in patients with chronically reduced renal function has been associated with acute kidney injury requiring dialysis. The risk of acute kidney injury may increase with increasing dose of the contrast agent; administer the lowest dose necessary for adequate imaging. Screen all patients for renal impairment by obtaining a history and/or laboratory tests. Consider follow-up renal function assessments for patients with a history of renal dysfunction
Cautions: Use cautiously in
Pregnancy Category:C
Breastfeeding: Safety unknown; Because many drugs are excreted in human milk, exercise caution when administered to a nursing woman.
