gadobenic acid

Action and Spectrum

Actions and spectrum: 

Actions: 

• Tissue Enhancement: gadobenic acid is administered intravenously before an MRI scan. Once in the bloodstream, it helps improve the visibility of certain tissues and structures within the body, making them easier to distinguish and analyze on the MRI images. 
• Paramagnetic Effect: gadobenic acid contains gadolinium, a paramagnetic element. When exposed to the strong magnetic field of an MRI scanner, gadolinium enhances the relaxation of nearby water protons, leading to increased signal intensity in the images. This enhancement improves the contrast between different tissues and helps identify abnormalities or pathologies. 

Spectrum:  

• Neuroimaging: gadobenic acid is used to enhance the visualization of brain and spinal cord structures. It aids in diagnosing conditions such as brain tumors, multiple sclerosis lesions, vascular malformations, and other neurological disorders. 
• Musculoskeletal Imaging: It is utilized to improve the clarity of joints, muscles, ligaments, and bones. This is helpful for diagnosing conditions like joint inflammation, tumors, and injuries. 
• Vascular Imaging: gadobenic acid can enhance the visualization of blood vessels and vascular structures, aiding in the assessment of blood flow, aneurysms, stenosis, and other vascular conditions. 
• Abdominal Imaging: The contrast agent can be used to improve the imaging of abdominal organs such as the liver, kidneys, and spleen. It assists in detecting lesions, tumors, and abnormalities. 
• Cardiac Imaging: gadobenic acid is also employed in cardiac MRI to enhance the imaging of the heart’s chambers, valves, and blood vessels. It aids in diagnosing conditions like cardiomyopathies, myocardial infarctions, and congenital heart defects. 

Drug Interaction

Adverse Reaction

Frequency defined 

1-10% 

Headache (1.2%) 

Feeling hot (1%) 

Nausea (1.3%) 

reactions at Injection site (1.1%)  

<1% 

Pyrexia (0.7%) 

Paresthesia (0.5%) 

Dysgeusia (0.7%) 

Hyperhidrosis (0.7%) 

Dizziness (0.5%)  

Post marketing Reports 

General disorders: injection site reactions like swelling, necrosis, burning sensation, blistering 

Skin: plaques 

Immune system disorders: hypersensitivity reactions, loss of consciousness & death 

fatigue, asthenia 

Black Box Warning

Black Box Warning: 

There is no specific black box warning associated with gadobenic acid. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Renal Impairment: Gadolinium-based contrast agents are primarily eliminated through the kidneys. Therefore, caution should be exercised when using gadobenic acid in patients with severe renal impairment due to the nephrogenic systemic fibrosis (NSF) risk. The benefit-to-risk ratio should be carefully evaluated in such patients. 
• Children and Pediatric Patients: Gadolinium-based contrast agents are used with caution in pediatric patients. The risks and benefits to be considered, and alternative imaging options should be explored when appropriate. 
• Hypersensitivity History: Patients with a history of hypersensitivity or allergic reactions to GBCAs or other medications should be evaluated for potential risks and benefits before receiving gadobenic acid.

Caution: 

• Hypersensitivity Reactions: Hypersensitivity reactions to gadolinium-based contrast agents (GBCAs) can occur, ranging from mild skin reactions to severe anaphylactic reactions. Patients with a history of allergic reactions to GBCAs or other medications should be closely monitored if gadobenic acid is considered for use. 
• Extravasation Risk: Extravasation refers to the accidental leakage of a drug or contrast agent from the vein into the surrounding tissue during administration. gadobenic acid is administered intravenously, and although it is well-tolerated, there is a potential risk of extravasation. Healthcare providers should take appropriate precautions to minimize this risk and promptly manage any instances of extravasation. 
• Pediatric Use: The use of gadolinium-based contrast agents in pediatric patients should be approached with caution. The benefits and risks of using gadobenic acid in children should be carefully considered, and alternative imaging options may be explored when appropriate.

Comorbidities: 

• Hypersensitivity: Patients with a history of hypersensitivity reactions to gadolinium-based contrast agents or other medications may be at an increased risk of experiencing allergic reactions when exposed to gadobenic acid.  
• Pregnancy and Breastfeeding: While gadobenic acid is used for imaging purposes and is not typically associated with pregnancy or lactation-related issues, healthcare providers should consider the potential risks and benefits of contrast agent administration in pregnant or breastfeeding individuals. The decision to use gadobenic acid in such cases should be made after careful evaluation. 
• Cardiovascular Conditions: Although gadobenic acid is primarily used for enhancing tissue contrast in MRI, individuals with certain cardiovascular conditions may require careful assessment and monitoring before undergoing contrast-enhanced imaging studies. 

Pregnancy / Lactation

Pregnancy consideration: Pregnancy Category not assigned 

Lactation: excreted into breast milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

gadobenic acid exerts its pharmacological effects through its gadolinium ion, which has paramagnetic properties. In a magnetic field, such as that generated by an MRI scanner, gadolinium ions interact with water protons in surrounding tissues. This interaction leads to a reduction in the relaxation times (T1 and T2) of nearby water protons. As a result, when a region of the body containing gadobenic acid is imaged, the presence of gadolinium enhances the signal intensity and contrast in the MRI images. This enhancement allows for improved visualization and differentiation of various tissues and structures.  

Pharmacodynamics: 

• Enhancement of Tissue Contrast: gadobenic acid exerts its pharmacodynamic effect by taking advantage of the unique properties of gadolinium, a paramagnetic element. When placed in a strong magnetic field, such as that generated by an MRI scanner, gadolinium ions interact with nearby water protons in the body’s tissues. 
• Relaxation Times Alteration: The interaction between gadolinium ions and water protons affects the relaxation times known as T1 (longitudinal relaxation time) and T2 (transverse relaxation time) in the surrounding tissues. gadobenic acid impacts the T1 relaxation time. T1 relaxation refers to the time it takes for excited protons to return to their equilibrium state. By shortening the T1 relaxation time of tissues, gadobenic acid enhances the signal intensity of the surrounding water protons during an MRI scan. 
• Increased Signal Intensity: As a result of the altered relaxation times, tissues containing gadobenic acid exhibit brighter signal intensity on T1-weighted MRI images. This increased signal intensity improves the differentiation between various tissues, structures, and abnormalities within the imaged region. gadobenic acid-enhanced imaging helps radiologists and healthcare professionals identify and characterize lesions, tumors, vascular abnormalities, and other conditions more accurately.

Pharmacokinetics: 

Absorption 

gadobenic acid is administered intravenously, typically as an injection, to enhance the contrast of tissues during magnetic resonance imaging (MRI). As a hydrophilic molecule, it remains within the extracellular fluid compartment and does not readily cross cell membranes. 

Distribution 

After administration, gadobenic acid rapidly distributes throughout the extracellular space of the body, including blood vessels and interstitial fluid. Due to its hydrophilic nature, it does not enter cells or penetrate the blood-brain barrier in significant amounts. 

Metabolism 

gadobenic acid is not metabolized in the body. It retains its chemical structure throughout its time in the body and is eliminated primarily unchanged. 

Elimination and excretion 

The primary route of excretion for gadobenic acid is through the kidneys. It is filtered by the glomeruli of the renal nephrons and is subsequently eliminated in the urine. 

Adminstartion

Administration: 

• Preparation: Before administering gadobenic acid, the healthcare professional will review the patient’s medical history, including any allergies, previous reactions to contrast agents, and current medications. It is important to inform the healthcare provider of any medical conditions or medications the patient is taking. 
• Intravenous Injection: Gadobenic acid is usually provided in vials as a sterile, aqueous solution ready for injection. The healthcare professional will prepare the injection site, often in a vein on the arm, and may use a smaller needle (butterfly needle) for patient comfort. The injection site may be cleansed with an antiseptic. 
• Injection Process: The healthcare professional will insert the needle into the vein and slowly inject the Gadobenic acid solution. The injection process is quick and painless. The patient may feel a sensation of warmth as the contrast agent enters the bloodstream, but this is a normal reaction. 
• Imaging Procedure: Once the Gadobenic acid is injected and has circulated through the bloodstream, the patient will undergo the MRI scan. The contrast enhancement effects of Gadobenic acid will help provide clear and detailed images of the targeted tissues and structures. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: gadobenic acid 

Pronounced: (gad-oh-BEN-ik acid)  

Why do we use gadobenic acid? 

• MRI Imaging: The primary and most common use of gadobenic acid is in MRI procedures. It is administered intravenously to patients undergoing MRI scans to improve the quality of images obtained. By enhancing the contrast between different tissues, gadobenic acid helps radiologists and healthcare providers visualize and identify various anatomical structures, lesions, tumors, blood vessels, and other abnormalities more clearly. 
• Neuroimaging: gadobenic acid-enhanced MRI is frequently used in neuroimaging studies to evaluate the brain and spinal cord. It aids in the diagnosis and characterization of conditions such as brain tumors, multiple sclerosis, vascular malformations, and inflammatory disorders. 
• Musculoskeletal Imaging: gadobenic acid can be used for imaging joints, muscles, tendons, and bones. It helps in assessing joint diseases, soft tissue abnormalities, ligament injuries, and bone pathologies. 
• Vascular Imaging: In vascular imaging, gadobenic acid-enhanced MRI provides detailed visualization of blood vessels, allowing the detection of vascular abnormalities, aneurysms, stenosis, and other circulatory issues. 
• Cardiac Imaging: gadobenic acid-enhanced MRI is also applied in cardiac imaging to visualize cardiac structures, assess heart function, and detect myocardial infarction (heart attack) and other heart-related conditions. 
• Breast Imaging: In certain cases, gadobenic acid-enhanced MRI may be used for breast imaging, especially when evaluating breast cancer and assessing the extent of disease.