gadolinium contrast (Omniscan)
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Introduction
Tradename: Omniscan
Classification
- group 1,2 & 3 agents[8]
* nearly all cases of nephrogenic systemic fibrosis occurred with group 1 agents, which are no longer used in the U.S. & most other countries.
Contraindications
- avoid in patients with GFR < 30 mL/min/1.73 m2[7]
- for group 2 agents, kidney function screening is optional[8]
- screening recommended for only available group 3 agent gadoxetate (Eovist)
- contrast-enhanced MRI with a group 2 agent should not be withheld, regardless of renal function
- hemodialysis removes gadolinium contrast
Adverse effects
- exposure to a gadolinium-contrast for MRA may be associated with the development of nephrogenic systemic fibrosis[1]
- deposition in brain with repeated use ?[2][4]
- no adverse effects identified[4]
- no association with risk of parkinsonism[3]
- retention in the body, including brain, for months to years[6]
More general terms
More specific terms
- gadobenate dimeglumine (Multihance)
- gadobutrol (Gadavist)
- gadofosveset (Vasovist)
- gadopentetate dimeglumine (Magnevist, Resovist)
- gadoterate; gadoterate meglumine (Doterem)
- gadoteridol (Prohance)
- gadoxetate (Eovist, Primovist)
Additional terms
References
- ↑ 1.0 1.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2006/safety06.htm#Gadolinium
FDA MedWatch http://www.fda.gov/medwatch/safety/2007/safety07.htm#Gadolinium - ↑ 2.0 2.1 FDA Safety Alert. July 27, 2015 Gadolinium-based Contrast Agents for Magnetic Resonance Imaging (MRI): Drug Safety Communication - FDA Evaluating the Risk of Brain Deposits With Repeated Use. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm456012.htm
- ↑ 3.0 3.1 Welk B et al Association Between Gadolinium Contrast Exposure and the Risk of Parkinsonism. JAMA. 2016;316(1):96-98 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27380348 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2531998
- ↑ 4.0 4.1 4.2 FDA Safety Alert. May 22, 2017 Gadolinium-based Contrast Agents for Magnetic Resonance Imaging (MRI): Drug Safety Communication - No Harmful Effects Identified With Brain Retention. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm559709.htm
- ↑ Firth S FDA Panel Backs New Warning for Gadolinium Contrast Agents Manufacturers could be required to conduct new studies. MedPage Today. September 11, 2017 https://www.medpagetoday.com/Radiology/DiagnosticRadiology/67811
- ↑ 6.0 6.1 FDA Safety Alert. Dec 19, 2017 Gadolinium-based Contrast Agents (GBCAs): Drug Safety Communication - Retained in Body; New Class Warnings. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm589580.htm
- ↑ 7.0 7.1 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ 8.0 8.1 8.2 8.3 Weinreb JC, Rodby RA, Yee J et al. Use of intravenous gadolinium-based contrast media in patients with kidney disease: Consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology 2021 Jan; 298:28. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33170103 https://pubs.rsna.org/doi/10.1148/radiol.2020202903