Drug Guide
Gadoxetate Disodium
Classification
Therapeutic: Diagnostic agent (Imaging contrast agent)
Pharmacological: Magnetic resonance imaging (MRI) contrast agent, hepatocyte-specific
FDA Approved Indications
- Liver imaging to detect and characterize hepatic lesions in adult and pediatric patients
Mechanism of Action
Gadoxetate disodium is a hepatocyte-specific MRI contrast agent that is taken up selectively by functioning hepatocytes and excreted into the biliary system, enhancing imaging of the liver and hepatobiliary system.
Dosage and Administration
Adult: 0.025 mmol/kg body weight, administered as an intravenous bolus; may repeat as necessary under physician supervision.
Pediatric: Dose based on body weight, similar to adults; consult specific guidelines.
Geriatric: Adjust based on renal function rather than age alone.
Renal Impairment: Use with caution; impaired renal function may increase risk of nephrogenic systemic fibrosis (NSF). Dose adjustments are not specified, but careful assessment is advised.
Hepatic Impairment: No specific dose adjustment guidelines, but hepatic function may influence image interpretation.
Pharmacokinetics
Absorption: Administered intravenously, so absorption phase bypassed.
Distribution: Distributes into extracellular and hepatocyte-specific compartments.
Metabolism: Metabolized minimally, primarily excreted unchanged.
Excretion: Excreted via hepatobiliary system into the bile and via renal pathways into the urine.
Half Life: Approximately 16 minutes in healthy adults.
Contraindications
- Hypersensitivity to gadoxetate disodium or any component of the formulation.
Precautions
- Use with caution in patients with renal impairment, especially those at risk for NSF; assess renal function before administration.
- Patients with known or suspected allergies to contrast media.
Adverse Reactions - Common
- Nausea (Rare)
- Headache (Rare)
- Injection site pain (Rare)
Adverse Reactions - Serious
- Anaphylactic reactions (Very rare)
- Nephrogenic systemic fibrosis (NSF) (Rare, primarily in patients with severe renal impairment)
Drug-Drug Interactions
- No significant interactions reported.
Drug-Food Interactions
- No known food interactions.
Drug-Herb Interactions
- No specific herb interactions identified.
Nursing Implications
Assessment: Assess renal function (serum creatinine, eGFR) prior to administration.
Diagnoses:
- Risk for allergic reaction
- Risk for nephrogenic systemic fibrosis in renal impairment.
Implementation: Administer IV bolus slowly under sterile conditions, monitor for adverse reactions, ensure proper patient hydration.
Evaluation: Monitor for allergic reactions, assess contrast-enhanced imaging results for accuracy.
Patient/Family Teaching
- Inform about the purpose of the contrast agent and potential side effects.
- Report any allergic symptoms immediately.
- Ensure hydration before and after the procedure.
Special Considerations
Black Box Warnings:
- Nephrogenic systemic fibrosis (NSF) in patients with severe renal impairment.
Genetic Factors: No specific genetic factors identified.
Lab Test Interference: None reported.
Overdose Management
Signs/Symptoms: Potential for allergic reactions or toxicity, though overdose is unlikely due to administration method.
Treatment: Supportive care; management of allergic reactions as per protocols.
Storage and Handling
Storage: Store at room temperature, protected from light.
Stability: Stable until expiration date if stored properly.