Gadolinium Based Contrast Agent – OptiMARK

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OptiMARK is a Gadolinium based contrast agent used to enhance the images obtained by MRI procedures. Also known as Gadoversetamide, the agent is manufactured by Mallinckrodt, which is a division of Tyco Healthcare. OptiMARK is considered a paramagnetic MRI contrast agent and is used to increase the detail of MRI images of the brain, spine, and liver. The solution is generally administered by IV but can also be injected directly into the blood stream. OptiMARK is a solution containing a chelating agent called versetamide that binds to the paramagnetic Gadolinium ion, effectively reducing its toxicity. When injected into the body, the contrast agent increases the brightness of tissues when scanned by an MRI. The images are taken within an hour of the injection of OptiMARK.

The common side effects associated with OptiMARK include headache, dizziness, nausea, taste perversion, and vasodilatation. These side effects are typically mild when they occur. Less commonly occurring side effects include fever, increased sweating, neck pain, chest pain, hypertension, constipation, dry mouth, edema, and muscle cramps. In rare cases, an allergic reaction may occur, either localized to the site of the injection or spread throughout the body. In the event of an allergic reaction to OptiMARK, patients should seek medical treatment immediately to prevent the reaction from becoming life-threatening. Any patient with a known allergic or hypersensitivity to any of the ingredients contained in OptiMARK should avoid using the agent.

OptiMARK, along with other Gadolinium based contrast agents, have been linked to an increased risk of developing Nephrogenic Systemic Fibrosis in patients with advanced kidney disease or kidney failure. Nephrogenic Systemic Fibrosis is a serious, life-threatening condition that affects the skin and internal organs of the affected individual. The condition causes the skin of the extremities to swell and tighten, causing the patient great discomfort. The tightening of the skin begins to restrict the movement of the muscles and joints, causing them to stiffen as well. Nephrogenic Systemic Fibrosis causes many patients to lose their mobility and many are confined to a wheelchair or become bedridden. There is no cure for Nephrogenic Systemic Fibrosis and an effective treatment has yet to be found.

Patients that have advanced to end-stage kidney disease should avoid using a Gadolinium based contrast agent, such as OptiMARK, unless there is no other way to obtain the needed images. Patients already receiving dialysis may initiate dialysis promptly after exposure to a Gadolinium based contrast agent to clear the agent from the body. Factors that may increase the risk of developing Nephrogenic Systemic Fibrosis after exposure to OptiMARK include higher than normal or repeated doses of a Gadolinium based contrast agent in a patient with advanced kidney disease or kidney failure, although cases of Nephrogenic Systemic Fibrosis have occurred after a single dose of a Gadolinium based contrast agent.

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