gadobenate dimeglumine: clinical use

Prescribing considerations

• Restrict use to essential delayed-phase liver MRI when unenhanced imaging cannot provide the required information.
• Screen all patients for renal dysfunction using laboratory testing, particularly older adults.
• Avoid use in severe renal impairment and around liver transplantation unless essential diagnostic information is otherwise unavailable.
• Ensure resuscitation facilities, trained personnel and hypersensitivity treatments are immediately available.
• Consider cardiovascular disease, asthma or other allergic disorders, epilepsy, brain lesions and the cumulative implications of gadolinium retention.
• Verify intravenous cannula placement and document the product, batch and amount administered.

Contraindications and cautions

• Hypersensitivity to gadobenate dimeglumine or any excipient.
• Previous allergic or adverse reaction to another gadolinium chelate.
• History of sensitivity to benzyl alcohol, which may be released in trace quantities during storage.

Monitoring

• Check renal function before administration.
• Observe during and after injection for hypersensitivity, cardiovascular or neurological reactions.
• Monitor for extravasation and promptly assess local symptoms.
• Record the exact gadolinium agent and batch.

Clinical pharmacology

A linear gadolinium chelate that shortens tissue-water proton relaxation times. Protein interaction increases relaxivity. It distributes mainly through plasma and extracellular fluid and is cleared predominantly unchanged by glomerular filtration, with a smaller biliary route. Gadolinium retention can occur in the brain and other tissues; the clinical consequences remain unknown.

Formulation and product differences

• Clear aqueous solution supplied in single-use glass vials.
• Draw into a syringe immediately before use. Do not dilute or mix with other medicinal products.
• Do not use if the container is damaged or the solution is discoloured or contains particles.