Dotarem Disease Interactions

Gadolinium based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Use of these agents should be avoided in these patients unless the diagnostic information is essential and unavailable with non- contrasted MRI or other diagnostic modalities. NSF may result in fatal or debilitating fibrosis affecting the skin, muscle and internal organs. The risk of NSF appears to be higher in patients with chronic severe renal disease and patients with acute kidney injury. Patients should be screened for acute renal injury and other conditions that might affect renal function such as age >60 years old, hypertension, and diabetes.

Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.

Patients with history of bronchial asthma might have an increased risk for a hypersensitivity reaction to gadolinium-based contrast agents. Patients should always be assessed for any history of a reaction to contrast media, asthma or other allergic disorders before the administration of these agents.

The use of certain Gadolinium-based contrast agents (GBCAs) in patients with severe renal or hepatic impairment may impair imaging performance. If GBCAs are used in these patients, complete MRI no later than 60 minutes after GBCAs administration and use a paired non-contrast and contrast MRI set for diagnosis. It is recommended to exercise caution when interpreting contrast MR images in the absence of companion non-contrast MR images