Dotarem vs Gadovist – Comparison Of Side Effects & Uses

Dotarem

It is the brand name of gadoterate meglumine, a substance that helps radiologists to observe abnormalities on images of the central nervous system, the part of the body which consists of the brain in the skull and the spinal cord.

It was originally approved by the US Food and Drug Administration on March 20th, 2013.

Uses

It is a gadolinium-based contrast agent that is used in magnetic resonance imaging (MRI) of the spine, brain, and associated tissues of people ages 2 years and older.

Dosage

The usual recommended dose is 0.2 mL/kg body weight.

Note – it will always be given to you by a trained health professional. It is injected into your veins just before the magnetic resonance imaging examination.

Side Effects and Precautions

Common side effects may include:

  • mild allergic reactions (usually affecting the skin, like – rash and itchiness);
  • abdominal pain;
  • hypotension or high blood pressure;
  • vomiting;
  • nausea;
  • a sensation of warmth or cold and/or pain at the injection site;
  • changes to taste;
  • dizziness;
  • a headache.

Rare side effects may include:

  • slow or fast heartbeats;
  • blurred vision;
  • pounding in the ears;
  • breathing difficulties;
  • racing heartbeat or pulse;
  • coughing;
  • nervousness;
  • sneezing;
  • swelling of the face, mouth, hands, feet, or throat;
  • hives;
  • eye irritation;
  • a runny nose;
  • whistling respiration.

Contraindications

Before using this paramagnetic contrast agent, tell your healthcare provider if you have:

  • severe heart and circulatory disorders;
  • bronchial asthma;
  • any type of allergy;
  • a low threshold for seizures;
  • you have had or will soon have a liver transplant;
  • very poor kidney function.

Alcohol

Avoid drinking alcoholic beverages while using this paramagnetic contrast agent since alcohol use can substantially increase the risk of severe side effects.

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Drug Interactions

Specific drug interaction studies with this substance have not been conducted.

Pregnancy & Breastfeeding

There are no well-done studies to determine whether this paramagnetic contrast agent is safe to use during pregnancy. Tell your healthcare provider that you are pregnant or plan to fall pregnant before using this paramagnetic contrast agent.

It is not known exactly whether this paramagnetic contrast agent passes into human breast milk or if it could negatively affect a breastfed infant. Tell your healthcare provider that you are breastfeeding a baby before using this paramagnetic contrast agent.

Gadovist

It is the brand name of a medication called gadobutrol.

Mechanism of Action

This magnetic liquid alters the way in which the magnetic resonance imaging machine detects certain tissues within the body.

Uses

It is given as an injection into your vein using a small needle by a healthcare professional for contrast enhancement during cranial and spinal MRI investigations.

Dosage

The usual recommended dose is 0.1 milliliter per kg body weight. Sometimes, a further injection of up to 0.2 milliliters per kg body weight within half-an-hour of the first injection may be given.

The maximum recommended dose is 0.3 milliliters per kg body weight.

Side Effects and Precautions

Common side effects may include:

  • nausea;
  • dizziness;
  • headaches.

Rare side effects may include:

  • unpleasant smells;
  • swelling of the eyelids, lips, face, tongue;
  • low blood pressure;
  • coughing or throat irritation;
  • pale skin;
  • itching or hives;
  • weakness;
  • difficulty breathing;
  • joint pain;
  • shortness of breath;
  • large areas of hardened skin;
  • wheezing;
  • feeling cold;
  • a feeling of suffocation;
  • flushing (redness);
  • abnormal heartbeat;
  • loss of consciousness;
  • uncontrolled shaking (convulsions).
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Contraindications

Before using this magnetic liquid, tell your healthcare provider:

  • if there are any implants or clips containing iron in your body;
  • if you suffer or have suffered from an allergy;
  • if you suffer from brain conditions with seizures or from other diseases of the nervous system;
  • if you have very poor kidney function;
  • if you had a previous reaction to any contrast agent.

Alcohol

Avoid drinking alcoholic beverages while using this contrast agent since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

Specific drug interaction studies with this substance have not been conducted.

Pregnancy & Breastfeeding

It is not known exactly whether this contrast agent passes into human breast milk or if it could negatively affect a breastfed infant. Tell your healthcare provider that you are breastfeeding a baby before using this contrast agent.

There are no well-done studies to determine whether this contrast agent is safe to use during pregnancy. Tell your healthcare provider that you are pregnant or plan to fall pregnant before using this contrast agent.

Bottom Line – Dotarem vs Gadovist

Dotarem (active ingredient – gadoterate meglumine) is a contrast agent that is indicated for intravenous use with magnetic resonance imaging in brain, spine and associated tissues in adult and pediatric patients.

Gadovist (active ingredient – gadobutrol) is a contrast medium for magnetic resonance imaging that is used for diagnostics of the brain, spine, and vessels.

According to a 2017 multicenter, randomized, double-blind, controlled intraindividual crossover study, no measurable difference in clinical benefit was observed between these contrast agents for overall visualization and characterization of primary brain tumors in 234 patients.

References

https://www.ncbi.nlm.nih.gov/pubmed/17193689
https://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/Development
https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/

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