Gadobenate (Intravenous)

Gadobenate is a contrast agent used during certain MRI scans to create an enhanced image for use by diagnostic technicians.

Overview

Gadobenate is known in the US under the brand name Multihance. The drug is used in a clinic or hospital environment as a diagnostic aid during certain MRI procedures.

The drug comes in solution form for intravenous administration. It is only ever administered by an appropriately trained medical professional prior to an MRI scan being taken.

MRI (magnetic resonance imaging) uses magnets and computer software technology to create pictures of particular parts of the patient's body. Gadobenate is generally used when MRI scans are being taken of the spine, brain and certain other areas of the body.

It should be noted that gadobenate cannot cure the condition that you are undergoing testing for. It is purely a diagnostic tool that is used to make the images produced during your MRI scans clearer.

Conditions treated

  • Diagnostic tool used for MRI scans

Type of medicine

  • MRI contrast agent
  • Intravenous solution

Side effects

In addition to providing the effects it is designed to produce, gadobenate sometimes causes a few unwanted side effects in some patients. Many patients do not suffer any unexpected effects at all when being treated with this drug. However, if you do notice anything odd, you may need to check with your doctor, in case the effect needs further medical treatment.

Some patients have reported the following side effects, following treatment with gadobenate. However, these effects are experienced only rarely. If you do notice any of these, you must tell your nurse or treating physician right away:

  • Yellow eyes or skin
  • Wheezing
  • Feeling unusually tired or weak
  • Unusual bruising or bleeding
  • Shaking or trembling of the hands or feet
  • Tiredness
  • Tightness of the chest
  • Swollen glands
  • Swelling of the face, eyes, or the inside of the nose
  • Swelling of the ankles or legs
  • Sweating
  • Increased sugar in the urine
  • Sudden shortness of breath or breathing problems
  • White spots, sores, or ulcers, in the mouth or around the lips
  • Sore throat
  • Skin rash
  • Shortness of breath
  • Shakiness of the arms, legs, feet, or hands
  • Redness of the skin, particularly around the ears
  • Swelling or puffiness of the eyelids, around the eyes, lips, face, or tongue
  • Problems with speech or speaking
  • Pounding in the ears
  • Pounding heartbeat
  • One-sided paralysis
  • Paling of the skin at the injection site
  • Generalized pale skin
  • Redness or pain at the injection site
  • Pain in the arms, shoulders, neck, or jaw
  • Numbness of the hands, feet, and around the mouth
  • Nervousness
  • Nausea
  • Muscle tightness or tension
  • Muscle stiffness
  • Lower back or side pain
  • Lightheadedness, dizziness, or fainting
  • Itching
  • Paralysis of the legs or arms
  • Hives
  • Headaches
  • A general feeling of illness or discomfort
  • A frequent urge to urinate
  • Fever
  • Rapid, slow, or irregular heartbeat
  • Fainting
  • Unexpectedly developing excessive muscle tone
  • Feelings of faintness, dizziness, or lightheadedness when rising suddenly from a prone or seated position
  • Dizziness
  • Swallowing or breathing difficulties
  • Problematic, fast, or noisy breathing, sometimes with wheezing
  • Burning, difficult, or painful urination
  • Problematic or labored breathing
  • Deep or fast breathing with dizziness
  • A decrease in urine production
  • Very dark urine
  • Coughing that often generates a pink frothy sputum
  • Cough
  • Convulsions
  • Confusion
  • Chills
  • Chest pain or discomfort
  • Sensations of burning, itching, crawling, numbness, tingling, prickling, or "pins and needles"
  • Blurred vision
  • Blue tinge to the fingernails and lips
  • Bloody or cloudy urine
  • Bladder pain
  • Tarry, black stools
  • Back pain
  • Anxiety
  • Stomach or abdominal pain

Gadobenate can cause some side effects that do not generally require further medical assistance. These effects usually disappear during treatment, once your body has adjusted to the drug. Your nurse or doctor may be able to give you some advice on how to prevent or manage some of the side effects.

If any of the effects that are mentioned below prove to be especially persistent or disabling, you should ask your nurse or doctor for advice.

  • Feeling very hot
  • Problems around the injection site, including:
  • feeling of pressure
  • skin discoloration
  • bleeding
  • blistering
  • burning
  • hives
  • coldness
  • infection
  • itching
  • inflammation
  • lumps
  • pain
  • redness
  • scarring
  • soreness
  • swelling
  • tenderness
  • stinging
  • ulceration

In rare instances, patients who have received gadobenate have reported some of the following side effects:

  • Vomiting
  • Tunnel vision
  • Swollen joints
  • Swelling of the eyelids
  • Stuffy nose
  • Stomach pain, discomfort, or upset
  • Shivering
  • Feeling very sleepy
  • Reddening of the skin
  • Redness of the eyes
  • Overly bright appearance of lights
  • Night blindness
  • Muscle spasms
  • Muscle cramps or aches
  • Loss of control of the bowels
  • Loss or lack of strength
  • Joint pain
  • Indigestion
  • Welts or hives
  • Heartburn
  • Hearing loss
  • Seeing halos around lights
  • Feeling unusually cold
  • Ear pain
  • Dry mouth
  • Double vision
  • Disturbed color perception
  • Difficulty in moving
  • Constipation
  • Diarrhea
  • Decreased responsiveness or awareness
  • Persistent tinnitus
  • Changes in your sense of taste
  • Changes in your sense of smell
  • Blurred or loss of vision
  • Belching
  • Unpleasant, bad, or unusual, aftertaste
  • Sour or acid stomach

It should be noted that the side effects mentioned in this guide may not be the only ones that are experienced by patients who have received gadobenate. If you notice any other effects, you should tell your nurse or treating physician as soon as possible.

Dosage

You will only ever be given gadobenate if you are in a hospital or clinic for diagnostic MRI tests.

The medication is administered intravenously via a needle placed into one of your veins, immediately prior to your MRI scan by an appropriately trained medical professional.

Drug interactions

Some medications must never be used at the same time as doing so can cause an undesirable interaction. In other cases, it may be appropriate to use both drugs together at a slightly adjusted dose or frequency rate, even though interactions could still take place. Be sure to tell your nurse or treating physician if you are using any prescription or over the counter drugs, before you receive your gadobenate infusion.

Other interactions

Some medicines should not be used at mealtimes or when eating particular food groups, as this could cause an interaction to take place. In addition, using tobacco or alcohol with some drugs can trigger interactions. Be sure to discuss this aspect of your treatment with your doctor.

Medical interactions

Some historical or existing medical conditions can cause interactions to occur while using this medication. For this reason it is very important that you discuss your medical history fully with your treating physician before receiving treatment with gadobenate.

Gadobenate should be used with caution in patients who have a history of any of the following conditions. These conditions can cause the side effects of the drug to become worse:

  • Seizures
  • Patients who have recently received a GBCA
  • Liver disease
  • Kidney problems, severe (recent or long-term)
  • Heart rhythm problems
  • Heart disease
  • Asthma or allergies
  • Anemia or any other blood disorder

This drug must be used with extreme care in patients who have a history of any of the following conditions, as to do so could trigger more serious side effects:

Although gadobenate can be used in patients with the hereditary disorder Dubin-Johnson syndrome, care should be taken as the slower removal of the drug from the body that would result could increase the effects.

Warnings

Before you decide to accept treatment with a particular medication, you should consider the benefits and risks of doing so. You can make this decision based on discussions with your medical team.

Be sure to tell your treating physician if you have ever suffered an allergic reaction to gadobenate or to any other medication. You should also mention if you have ever had a bad reaction to food colors, preservatives, particular food groups, or animal by-products.

Pediatric

Although there have been no studies carried out to date that would indicate potential problems in using gadobenate in children over two years of age, no such research has been undertaken in children under the age of two years.

No studies have been performed into the use of gadobenate MultipackTM in children. It is therefore not known whether the use of this drug is safe or effective in these cases.

Geriatric

Although there has been no research to suggest that using gadobenate in elderly patients is inappropriate, caution should be taken. Geriatrics are more likely to suffer from age-related kidney problems, so the dose of the drug may require adjustment to take this into account.

Pregnancy and breastfeeding

There is nothing to suggest that using gadobenate in pregnant women could present a risk to the fetus. However, you should inform your treating physician if you are pregnant and weigh the benefits against the potential risks of receiving this medication.

Similarly, there have been no studies that show that this drug passes into breast milk. However, you may wish to consider using an alternative form of feeding solution for your infant if you are breastfeeding. Once your diagnostic tests are over and the drug has passed out of your body, you may then resume breastfeeding.

Medical complications

You must attend your doctor on a regular basis throughout your treatment with gadobenate to make sure that the drug has not caused any side effects and is working effectively. These appointments will also be used to discuss the results of your MRI tests and to map out future treatments and tests.

Some patients may develop a serious disease called nephrogenic systemic fibrosis (NSF), following treatment with gadobenate. If you or your child have any of the following symptoms, check with your GP right away:

  • Itching or burning of the skin
  • Dark or red patches on the skin
  • Swelling of areas of the skin
  • Hardening or tightening of the skin
  • Stiffness of joints
  • Limited range of movement of legs and arms
  • Deep pain in the hip bones or ribs
  • Muscle weakness

Anaphylaxis has been noted in some patients who have received gadobenate. This is a potentially life-threatening allergic reaction that always requires prompt medical assistance. Tell your nurse right away if you notice any of the following symptoms immediately after receiving this drug:

  • Clammy, cold skin
  • Confusion
  • Lightheadedness and dizziness
  • Skin rash
  • Sweating
  • Swelling of the throat, tongue, or face
  • Chest pain

Check with your nurse or doctor immediately if you notice any mild burning feelings, reddening or swelling, or sensations of cold or warmth around the injection site.

Some patients can experiences incidences of arrhythmia, including QT prolongation when having treatment with gadobenate. This condition causes alterations to your heartbeat and sometimes causes fainting. If you notice any signs of heart rhythm issues, including pounding, rapid, or irregular heartbeats, tell your doctor right away.

Before undertaking any form of medical tests, you must tell the presiding physician or nurse that you have received treatment with gadobenate. Some test results can be affected by this medication.

You must not use any other form of medication while you are receiving gadobenate, including over the counter drugs, herbal remedies, vitamin supplements, and diet pills, unless their use has first been discussed with your treating physician.

Storage

This medication is not prescribed for home use. It will be stored in an appropriate setting in the hospital or clinic where you will be receiving your treatment.

Summary

Gadobenate is only used in hospitals and medical clinics prior to MRI diagnostic scans. The drug is a contrasting agent. It is administered via intravenous injection by a trained medical professional, immediately prior to your scan. This medication cannot cure your condition; it is used purely as a diagnostic tool.

This medicine can cause a number of potentially serious side effects in some patients who have a history of certain medical conditions. You should therefore attend your doctor for check-ups following your treatment to make sure that the drug has not caused any persistent problems.