Medical Editor: John P. Cunha, DO, FACOEP
Dotarem (gadoterate meglumine) is a paramagnetic macrocyclic ionic contrast agent for intravenous use with magnetic resonance imaging (MRI) in brain (intracranial), spine and associated tissues in adult and pediatric patients (2 years of age and older) to detect and visualize areas with disruption of the blood brain barrier (BBB) and/or abnormal vascularity. Common side effects of Dotarem include:
- feeling cold
- numbness or tingling
- changes in taste
- pain in extremities
- high blood pressure
- and injection site reactions (inflammation, itching, warmth, pain, coldness, or burning sensation)
For adult and pediatric patients (2 years and older), the recommended dose of Dotarem is 0.2 mL/kg (0.1 mmol/kg) body weight administered as an intravenous bolus injection, manually or by power injector, at a flow rate of approximately 2 mL/second for adults and 1-2 mL/second for pediatric patients. Dotarem may interact with other drugs. Tell your doctor all medications and supplements you use. During pregnancy, Dotarem should be used only if prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Our Dotarem (gadoterate meglumine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
GBCAs have been associated with a risk for NSF [see WARNINGS AND PRECAUTIONS]. Confirmed diagnosis of NSF has not been reported in patients with a clear history of exposure to DOTAREM alone.
Hypersensitivity reactions and acute kidney injury are described in other sections of the labeling [see WARNINGS AND PRECAUTIONS].
Clinical Studies Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
The data described below reflect DOTAREM exposure in 2867 patients, representing 2682 adults and 185 pediatric patients. Overall, 55% of the patients were men. In clinical trials where ethnicity was recorded, the ethnic distribution was 81% Caucasian, 11% Asian, 4% Black, and 4% others. The average age was 53 years (range from < 1 week to 97 years).
Overall, 4% of patients reported at least one adverse reaction, primarily occurring immediately or within 24 hours following DOTAREM administration. Most adverse reactions were mild or moderate in severity and transient in nature.
Table 2 lists adverse reactions that occurred in ≥ 0.2% patients who received DOTAREM.
Table 2: Adverse Reactions in Clinical Trials
n = 2867
|Injection Site Pain||0.4%|
|Injection Site Coldness||0.2%|
Adverse reactions that occurred with a frequency < 0.2% in patients who received DOTAREM include: feeling cold, feeling hot, burning sensation, somnolence, pain, dizziness, dysgeusia, blood creatinine increased, hypotension, hypertension, asthenia, fatigue, injection site reactions (inflammation, extravasation, pruritus, swelling, warmth), paraesthesia, pruritus, laryngeal discomfort, pain in extremity, vomiting, anxiety and palpitations.
Adverse Reactions In Pediatric Patients
During clinical trials, 185 pediatric patients (52 aged < 24 months, 33 aged 2 - 5 years, 57 aged 6 - 11 years and 43 aged 12 - 17) received DOTAREM. Overall, 7 pediatric patients (3.8%) reported at least one adverse reaction following DOTAREM administration. The most frequently reported adverse reaction was headache (1.1%). Most adverse events were mild in intensity and transient in nature.
The following additional adverse reactions have been identified during postmarketing use of DOTAREM. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Table 3: Adverse Reactions in the Postmarketing
|System Organ Class||Adverse Reaction|
|Cardiac Disorders||bradycardia, tachycardia, arrhythmia|
|Immune System Disorders||Hypersensitivity / anaphylactoid reactions including cardiac arrest, respiratory arrest, cyanosis, pharyngeal edema, laryngospasm, bronchospasm, angioedema, conjunctivitis, ocular hyperemia, eyelid edema, lacrimation increased, hyperhidrosis, urticaria|
|Nervous System Disorders||coma, convulsion, syncope, presyncope, parosmia, tremor|
|Musculoskeletal and Connective Tissue Disorders||muscle contracture, muscle weakness|
|Gastrointestinal Disorders||diarrhea, salivary hypersecretion|
|General Disorders and Administration Site Conditions||malaise, fever|
|Skin and Subcutaneous Tissue Disorders||NSF, in patients whose reports were confounded by the receipt of other GBCAs or in situations where receipt of other GBCAs could not be ruled out. No unconfounded cases of NSF have been reported with DOTAREM.|
|Vascular Disorders||superficial phlebitis|
Read the entire FDA prescribing information for Dotarem (Gadoterate Meglumine for Use with Magnetic Resonance Imaging)
© Dotarem Patient Information is supplied by Cerner Multum, Inc. and Dotarem Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.