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Gadolinium Based Contrast Agent – ProHance

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ProHance is a MRI contrast agent manufactured by Bracco Diagnostics. It received approval from the US Food and Drug Administration in 1992 and was released to the retail market later that year. ProHance is used to enhance the images obtained by MRI procedures and is used to detail any abnormal tissue in the brain, spine, and other associated tissues. It can also be used to detail lesions in the head or neck of adult patients.

Also known as Gadoteridol, ProHance is considered a paramagnetic contrast agent containing Gadolinium ions to increase its magnetic properties. When used in conjunction with MRI, it enhances and improves the images of the body and highlights any areas of abnormal growth. The solution is given by injection directly into the blood stream. The dosage is determined by the patient’s body weight and the MRI scan is taken within an hour of the initial injection. ProHance is eliminated from the body by the kidneys through the urine in about 24 hours. The solution can be used in the MRI procedures of both adults and children.

The most common side effects associated with the use of ProHance include nausea and an unusual taste in the mouth. In rare cases, the solution can cause facial edema, abdominal cramping, headache, fever, dry mouth, and vomiting. Some individuals who have taken ProHance experience an allergic reaction, characterized by pain or discomfort at the site of the injection, itching, watery eyes, shortness of breath, and a rash. ProHance can also affect the circulatory system, causing low blood pressure, palpitations, and angina pectoris.

ProHance, along with other Gadolinium based contrast agents, have been recently associated with the development of a very serious, debilitating condition called Nephrogenic Systemic Fibrosis. Nephrogenic Systemic Fibrosis is a progressive skin disorder characterized by the tightening and thickening of areas of the skin on the arms, legs, and occasionally the trunk of the body. This restricts the movement of the muscles and joints of the extremities, eventually causing a total loss of mobility. In some cases, individuals with Nephrogenic Systemic Fibrosis lose their mobility and become bedridden or wheelchair bound within weeks of the onset of the condition. There is no cure for Nephrogenic Systemic Fibrosis and an effective treatment is yet to be found.

In 2006, the US Food and Drug Administration released a Public Health Advisory warning the healthcare community about the link between the use of Gadolinium based contrast agents such as ProHance and the development of Nephrogenic Systemic Fibrosis in individuals with impaired renal function. The disorder seems to only occur in patients with moderate to end-stage kidney disease and kidney failure, causing some experts to speculate that the condition occurs because the Gadolinium based contrast agent is not cleared from the body by the kidneys effectively. Any individual with impaired renal function is advised to avoid the use of Gadolinium based contrast agents, as they are at a significantly increased risk of developing Nephrogenic Systemic Fibrosis.

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