Adult Dosing
Contrast use in imaging (MRI)
- 0.1 mL/kg (0.025 mmol/kg) undiluted IV at a flow rate of 2 mL/sec
- Flush the IV canula with physiological saline
Notes- Perform a precontrast MRI and begin dynamic imaging approx 15-20 secs after completion of injection
- Begin hepatocyte imaging at approx 20 mins post injection (may be performed up to 120 mins post injection)
- In patients with elevated intrinsic levels of bilirubin (3 mg/dL) or ferritin, perform hepatocyte imaging within 60 mins post injection
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- For IV administration only. Ensure catheter and venous potency to avoid extravasation. Avoid IM injection due to risk of myocyte necrosis and inflammation
- Increased risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (GFR <30 mL/min/1.73 m2); patients with acute renal insufficiency due to hepato-renal syndrome; perioperative hepatic transplantation period. Avoid use unless diagnosis cannot be established by non-contrast based MRI
- Evaluate all patients for renal dysfunction. Do not exceed recommended dose and re-administer only after a sufficient period of time has elapsed after the first dose
- Consider prompt initiation of hemodialysis following administration of gadolinium-based contrast agent in patients receiving hemodialysis
- Hypersensitivity reactions, including anaphylactoid and/or anaphylactic reactions w/ cardiovascular, respiratory and cutaneous manifestations may result from administration of gadoxetate. Screen all patients for history of sensitivity to contrast media, bronchial asthma, and/or allergic disorders
- Elevated bilirubin or ferritin levels may reduce hepatic contrast of gadoxetate. Complete MR imaging within 60 minutes after gadoxetate administration and use a paired non-contrast and contrast MRI image set for diagnosis in patients with ESRD or hepatic failure
- Falsely high or low iron levels may be obtained for up to 24 hrs post administration
- QTc prolongation has been reported following gadofosveset administration. Obtain baseline ECG and serum electrolyte levels in patients at risk for prolongation of QTc interval
Cautions: Use cautiously in
- Renal impairment
- Prolonged QT syndrome
- Co administration of drugs known to prolong QT interval
- Hx of cardiac disease
- Electrolyte imbalances
- Geriatric population
Pregnancy Category:C
Breastfeeding: Safety unknown; manufacturer advises caution
