OptiMARK Disease Interactions

Gadolinium- based contrast agents (GBCAs) such as gadopentetate dimeglumine, gadoteridol and gadodiamide are contraindicated in patients with chronic, severe kidney disease (glomerular filtration rate, GFR < 30 mL/min), or acute kidney injury. GBCAs increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Their use should be avoided in these patients unless the diagnostic information is essential and not available with non- contrasted MRI or other modalities. NSF may result in fatal or debilitating fibrosis affecting the skin, muscle and internal organs. Caution is advised in patients at risk for chronically reduced renal function (age >60 years, hypertension or diabetes). Always estimate the glomerular filtration rate (GFR) through laboratory testing.

Seizures have been reported during post-approval use of gadoversetamide. Although is not possible to reliably estimate their frequency or establish a causal relationship, caution is advised in patients with seizure disorders.

Severe and fatal hypersensitivity reactions including anaphylaxis have been observed with administration of gadolinium based contrast agents, including gadoteridol. Patients with a history of allergy, drug reactions or other hypersensitivity-like disorders should be closely observed during the procedure and for several hours after drug administration. If a reaction occurs, stop administering and immediately begin appropriate therapy including resuscitation.