Drug Guide
Gadoteridol
Classification
Therapeutic: Contrast agent for MRI
Pharmacological: Gadolinium-based contrast agent
FDA Approved Indications
- Use as an intravenous contrast agent in magnetic resonance imaging (MRI) for detecting and delineating CNS lesions, vascular abnormalities, and other conditions.
Mechanism of Action
Gadoteridol is a gadolinium-based contrast agent that shortens the relaxation times of tissues where it accumulates, enhancing the contrast on MRI images.
Dosage and Administration
Adult: Typically 0.1 mmol/kg of body weight, given as an IV bolus. Adjust based on clinical indication and patient condition.
Pediatric: Doses similar to adults, adjusted based on weight and clinical situation. Specific pediatric dosing should follow institution protocols.
Geriatric: Use caution; consider renal function, but no specific age adjustment unless renal impairment is present.
Renal Impairment: Use caution in patients with impaired renal function; dose adjustment may be necessary. Evaluate renal function prior to administration.
Hepatic Impairment: No specific adjustments required.
Pharmacokinetics
Absorption: Administered intravenously; absorption phase not applicable.
Distribution: Distributes rapidly within the vascular and interstitial space.
Metabolism: Not extensively metabolized; excreted unchanged.
Excretion: Primarily excreted unchanged via the kidneys.
Half Life: Approximately 1.5 hours in individuals with normal renal function.
Contraindications
- Known hypersensitivity to gadoteridol or other gadolinium-based contrast agents.
- Severe renal impairment (eGFR <30 mL/min/1.73m²) unless necessary.
Precautions
- Use with caution in patients with compromised renal function, history of contrast reactions, or allergies. Consider risk vs benefit in pregnancy and breastfeeding.
Adverse Reactions - Common
- Nausea (Rare)
- Headache (Rare)
- Injection site reactions (Rare)
Adverse Reactions - Serious
- Anaphylactic reactions (Rare)
- Nephrogenic systemic fibrosis (NSF) in at-risk patients (Very rare but serious, associated with renal impairment)
Drug-Drug Interactions
- No significant interactions reported
Drug-Food Interactions
- No known interactions
Drug-Herb Interactions
- No known interactions
Nursing Implications
Assessment: Evaluate renal function prior to administration, monitor for allergic reactions during and after injection.
Diagnoses:
- Risk for allergic reaction
- Risk for nephrogenic systemic fibrosis in vulnerable patients
Implementation: Administer IV bolus as prescribed, ensure appropriate hydration, monitor vital signs and patient response during and after administration.
Evaluation: Assess for adverse reactions, ensure no signs of allergic or systemic responses.
Patient/Family Teaching
- Inform about the purpose of the contrast agent, possible side effects, and to report any allergic reactions or symptoms such as rash, difficulty breathing, or swelling.
Special Considerations
Black Box Warnings:
- Nephrogenic systemic fibrosis (NSF) in patients with severe renal impairment.
Genetic Factors: No specific genetic predispositions identified.
Lab Test Interference: May cause transient alterations in renal function tests; no significant interference with other labs.
Overdose Management
Signs/Symptoms: Potential for hypersensitivity or nephrotoxicity; may see systemic reactions or worsening renal function.
Treatment: Supportive care, maintain airway, breathing, circulation, and manage symptoms. Dialysis may be considered in severe cases with renal impairment.
Storage and Handling
Storage: Store at controlled room temperature 20-25°C (68-77°F). Keep in original packaging.
Stability: Stable until expiration date indicated on packaging.