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As a free solubilized aqueous ion, gadolinium(III) is highly toxic, but the chelated compounds are generally regarded as safe for individuals without kidney disease. Free Gd 3+ has a median lethal dose of 0.34 mmol/kg (IV, mouse) [ 27 ] or 100–200 mg/kg, but the LD50 is increased by a factor of 31 times [ 28 ] when Gd 3+ is chelated.
Nephrogenic systemic fibrosis is a rare syndrome that involves fibrosis of the skin, joints, eyes, and internal organs. NSF is caused by exposure to gadolinium in gadolinium-based MRI contrast agents (GBCAs) in patients with impaired kidney function.
Those most at risk for NSF include patients with chronic or severe kidney disease and acute kidney injury. [4] [5] [10] The rate of side effects are uncommon (0.1 to 1.0%), including nausea, headache, injection site reactions, hypertension, hypotension, dizziness, feeling hot, and somnolence. [11]
Gadodiamide is one of the main GBCA associated with nephrogenic systemic fibrosis (NSF), a toxic reaction occurring in some people with kidney problems. [6] No cases have been seen in people with normal kidney function. [7] A 2015 study found gadolinium deposited in the brain tissue of people who had received gadodiamide. [8]
The most severe reaction to gadobutrol is nephrogenic system fibrosis (NSF) among patients with impaired elimination of the drug. The risk is highest among patients with chronic, impaired kidney function and those with acute kidney injury. NSF may result in death or severe impairment of the skin, muscle, and internal organs. [8]
Gadopentetic acid, sold under the brand name Magnevist, is a gadolinium-based MRI contrast agent. [2]It is usually administered as a salt of a complex of gadolinium with DTPA (diethylenetriaminepentacetate) with the chemical formula A 2 [Gd(DTPA)(H 2 O)]; when cation A is the protonated form of the amino sugar meglumine the salt goes under the name "gadopentetate dimeglumine".
Deprescribing is an option for patients who experience unpleasant side effects, said Sue Clenton, MD, a consultant clinical oncologist at Weston Park Cancer Centre in Sheffield, U.K.
Side effects include vomiting, skin flushing, headache, itchiness, kidney problems, and low blood pressure. [4] Less commonly allergic reactions or seizures may occur. [4] Allergies to povidone-iodine or shellfish do not affect the risk of side effects more than other allergies. [6] Use in the later part of pregnancy may cause hypothyroidism in ...