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gadolinium contrast (Omniscan)

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 - scheduling MRI just prior to dialysis is reasonable, but not mandatory [8] Adverse effects: 1) exposure to a gadolinium-contrast for MRA may be associated with the development of nephrogenic systemic fibrosis [1] 2) deposition in brain with repeated use ? [2,4] - no adverse effects identified [4] 3) no association with risk of parkinsonism [3] 4) retention in the body, including brain, for months to years [6]

Interactions

drug adverse effects of contrast agents

Related

gadolinium [Gd]

Specific

gadobenate dimeglumine (Multihance) gadobutrol (Gadavist) gadofosveset (Vasovist) gadopentetate dimeglumine (Magnevist, Resovist) gadoterate; gadoterate meglumine (Doterem) gadoteridol (Prohance) gadoxetate (Eovist, Primovist)

General

contrast agent

References

  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. 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. Welk B et al Association Between Gadolinium Contrast Exposure and the Risk of Parkinsonism. JAMA. 2016;316(1):96-98 PMID: 27380348 http://jama.jamanetwork.com/article.aspx?articleid=2531998
  4. 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
  5. 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. 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. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  8. 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: 33170103 https://pubs.rsna.org/doi/10.1148/radiol.2020202903