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Dotarem Side Effects

Generic Name: gadoterate meglumine

For the Consumer

Common side effects include:

  • reactions along the venous injection site, such as mild and transient burning or pain, or feeling of warmth or coldness at the injection site
  • headache
  • nausea
  • abnormal taste
  • feeling hot.

For the Professional

Adverse Reactions

GBCAs have been associated with a risk for NSF [see Warnings and Precautions (5.1)]. Confirmed diagnosis of NSF has not been reported in patients with a clear history of exposure to Dotarem alone.

Hypersensitivity reactions and acute kidney injury are described in other sections of the labeling [see Warnings and Precautions (5.2) and (5.3)].

Clinical Studies Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The data described below reflect Dotarem exposure in 2867 patients, representing 2682 adults and 185 pediatric patients. Overall, 55% of the patients were men. In clinical trials where ethnicity was recorded, the ethnic distribution was 81% Caucasian, 11% Asian, 4% Black, and 4% others. The average age was 53 years (range from < 1 week to 97 years).

Overall, 4% of patients reported at least one adverse reaction, primarily occurring immediately or within 24 hours following Dotarem administration. Most adverse reactions were mild or moderate in severity and transient in nature.

Table 2 lists adverse reactions that occurred in ≥ 0.2% patients who received Dotarem.

Table 2: Adverse Reactions in Clinical Trials

Reaction

Rate (%)

n=2867

Nausea

0.6%

Headache

0.4%

Injection Site Pain

0.4%

Injection Site Coldness

0.2%

Rash

0.2%

Adverse reactions that occurred with a frequency < 0.2% in patients who received Dotarem include: feeling cold, feeling hot, burning sensation, somnolence, pain, dizziness, dysgeusia, blood creatinine increased, hypotension, hypertension, asthenia, fatigue, injection site reactions (inflammation, extravasation, pruritus, swelling, warmth), paresthesia, pruritus, laryngeal discomfort, pain in extremity, vomiting, anxiety and palpitations.

Adverse Reactions in Pediatric Patients

During clinical trials, 185 pediatric patients (52 aged < 24 months, 33 aged 2 - 5 years, 57 aged 6 - 11 years and 43 aged 12 – 17 years) received Dotarem. Overall, 7 pediatric patients (3.8%) reported at least one adverse reaction following Dotarem administration. The most frequently reported adverse reaction was headache (1.1%). Most adverse events were mild in intensity and transient in nature.

Postmarketing Experience

The following additional adverse reactions have been identified during postmarketing use of Dotarem. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Table 3: Adverse Reactions in the Postmarketing Experience

System Organ Class

Adverse Reaction

Cardiac Disorders

bradycardia, tachycardia, arrhythmia

Immune System Disorders

hypersensitivity /anaphylactoid reactions including cardiac arrest, respiratory arrest, cyanosis, pharyngeal edema, laryngospasm, bronchospasm, angioedema, conjunctivitis, ocular hyperemia, eyelid edema, lacrimation increased, hyperhidrosis, urticaria

Nervous System Disorders

coma, convulsion, syncope, presyncope, parosmia, tremor

Musculoskeletal and Connective Tissue Disorders

muscle contracture, muscle weakness

Gastrointestinal Disorders

diarrhea, salivary hypersecretion

General Disorders and Administration Site Conditions

malaise, fever

Adverse events with variable onset and duration have been reported after GBCA administration [see Warnings and Precautions (5.3)]. These include fatigue, asthenia, pain syndromes, and heterogeneous clusters of symptoms in the neurological, cutaneous, and musculoskeletal systems.

Skin and Subcutaneous Tissue Disorders

NSF, in patients whose reports were confounded by the receipt of other GBCAs or in situations where receipt of other GBCAs could not be ruled out.

No unconfounded cases of NSF have been reported with Dotarem.

Gadolinium-associated plaques

Vascular Disorders

superficial phlebitis