Version July 2025
Dosage guidance:
Safety: Dosing presented in mL/kg and mmol/kg; use caution. Parenteral solution contains 0.5 mmol/mL of gadopentetate dimeglumine.
Dosage form information: Not available in the United States.
Body, CNS, head, and neck MRI: Infants, Children, and Adolescents: IV: 0.2 mL/kg (0.1 mmol/kg); maximum dose: 20 mL/dose; imaging must be completed within 1 hour of injection.
Infants, Children, and Adolescents: IV:
GFR >30 mL/minute/1.73 m2: There are no dosage adjustments provided in the manufacturer's labeling. Risk for nephrogenic systemic fibrosis (NSF) development increases as kidney function decreases.
GFR <30 mL/minute/1.73 m2: Use contraindicated.
Dialysis: There are no pediatric-specific recommendations; based on experience in adult patients, the following has been observed:
Hemodialysis: If administered to patients already receiving hemodialysis, consider prompt hemodialysis following exposure (eg, within 3 hours) (Ref). Data has shown hemodialysis enhances gadolinium elimination with average gadolinium excretory rates of 78%, 96%, and 99% in the first, second, and third hemodialysis sessions, respectively (Ref).
Peritoneal dialysis: Likely to be less efficient at clearing gadolinium (Ref).
Infants, Children, and Adolescents: IV:
Mild to moderate impairment: There are no pediatric-specific recommendations in the manufacturer's labeling; based on adult data, no dosage adjustment necessary.
Severe impairment: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); does not undergo significant liver metabolism.
(For additional information see "Gadopentetate dimeglumine (United States: Not available): Drug information")
CNS, head, and neck imaging: IV: 0.1 mmol/kg (0.2 mL/kg) (maximum single dose: 20 mL); may repeat within 30 minutes if clinically indicated.
GFR >30 mL/minute/1.73 m2: There are no dosage adjustments provided in the manufacturer's labeling; use with caution. Risk for NSF development increases as renal function decreases.
GFR <30 mL/minute/1.73 m2: Use contraindicated.
Hemodialysis: If administered to patients already receiving hemodialysis, consider prompt hemodialysis following exposure (eg, within 3 hours) (Ref). Data has been shown hemodialysis enhances gadolinium elimination with average gadolinium excretory rates of 78%, 96%, and 99% in the first, second, and third hemodialysis sessions, respectively (Ref).
Peritoneal dialysis: Likely to be less efficient at clearing gadolinium (Ref).
Mild to moderate impairment: No dosage adjustment necessary.
Severe impairment: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); does not undergo significant hepatic metabolism.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%:
Gastrointestinal: Nausea (3%), vomiting (1%)
Hypersensitivity: Hypersensitivity reaction (2%)
Local: Discomfort at injection site (7%), local pain (3%)
Nervous system: Dizziness (2%), headache (9%), paresthesia (1%)
Frequency not defined:
Cardiovascular: Edema, hypotension
Dermatologic: Urticaria
Postmarketing:
Cardiovascular: Angina pectoris, bradycardia, cardiac arrhythmia, chest pain, ECG changes, flushing, increased blood pressure, peripheral edema, substernal pain, syncope, tachycardia, thrombophlebitis, vasodilation
Dermatologic: Diaphoresis, pallor
Endocrine & metabolic: Increased serum iron, increased thirst
Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, dysgeusia, mouth pain, oral paresthesia, sialorrhea, stomach discomfort, toothache, xerostomia
Genitourinary: Urinary incontinence, urinary urgency
Hepatic: Increased liver enzymes, increased serum bilirubin
Hypersensitivity: Angioedema, nonimmune anaphylaxis, type IV hypersensitivity reaction
Local: Injection-site reaction (including bleeding at injection site, burning sensation at injection site, erythema at injection site, inflammation at injection site, injection-site coldness, injection-site paresthesia, injection-site phlebitis, irritation at injection site, local thrombophlebitis, localized edema, localized warm feeling, pain at injection site, swelling at injection site, tissue necrosis at injection site)
Nervous system: Agitation, altered sense of smell, anxiety, asthenia, burning sensation, chills, coma, confusion, decreased body temperature, disorientation, drowsiness, fatigue, feeling hot, hyperesthesia, malaise, seizure, sensation of cold, speech disturbance, tremor
Neuromuscular & skeletal: Arthralgia, back pain, limb pain
Ophthalmic: Eye pain, lacrimation, nystagmus disorder, visual disturbance, visual field defect
Otic: Auditory impairment, otalgia, tinnitus
Renal: Acute kidney injury, increased serum creatinine, nephrogenic systemic fibrosis
Respiratory: Apnea, bradypnea, cough, pharyngolaryngeal pain, pulmonary edema, respiratory distress, rhinorrhea, tachypnea, throat irritation
Miscellaneous: Fever
Hypersensitivity to gadopentetate dimeglumine or any component of the formulation; chronic severe kidney disease (GFR <30 mL/minute/1.73 m2); acute kidney injury; neonates up to 4 weeks of age due to their immature renal function.
Concerns related to adverse effects:
• BP changes: May cause transient decreases or increases in BP; use caution when driving or operating machinery.
• Extravasation: Vesicant; ensure proper needle/catheter/line placement prior to and during administration. Avoid extravasation. Skin and soft tissue necrosis, thrombosis, fasciitis, and compartment syndrome have occurred (rare) at injection site or limb used for injection; phlebitis and thrombophlebitis may be observed usually within 24 hours of injection and resolves with supportive treatment.
• Gadolinium retention: Gadolinium is retained for months or years in brain, bone, skin, and other organs (kidney, liver, spleen); the highest concentration and longest duration have been found in the bone. Linear GBCAs (gadodiamide and gadoversetamide > gadoxetate disodium, gadopentetate dimeglumine, and gadobenate dimeglumine) result in more retention than macrocyclic GBCAs (gadoterate meglumine, gadobutrol, and gadoteridol). Pathologic and clinical consequences of gadolinium retention in skin and other organs have been established in patients with impaired renal function; there also have been rare reports of pathologic skin changes in patients with normal renal function. Consequences of gadolinium retention in the brain or in patients with normal renal function have not been established. Patients with normal renal function that may be at higher risk for gadolinium retention include: patients requiring multiple lifetime doses, pregnant and pediatric patients, and patients with inflammatory conditions; take GBCA retention characteristics into consideration for these patients. Minimize repetitive GBCA imaging studies.
• Hypersensitivity reactions: Hypersensitivity, including anaphylactic reactions (rare), may occur; appropriate equipment (eg, ventilator) and emergency medications (eg, epinephrine) should be available during use. Delayed reactions may also occur (within several hours of administration). Patients with a history of allergic reactions and/or bronchial asthma may be at an increased risk for developing hypersensitivity reactions; use caution in these patients.
• Nephrogenic systemic fibrosis: [Canadian Boxed Warning] : Gadolinium-based contrast agents (GBCAs) exposure may increase the risk for nephrogenic systemic fibrosis (NSF) in patients with renal impairment; avoid use unless GBCA enhanced imaging is essential for diagnostic purposes. Use is contraindicated in patients with acute kidney injury or chronic, severe renal disease (GFR <30 mL/minute/1.73 m2), and neonates up to 4 weeks of age. The risk appears lower in patients with moderate, chronic renal disease (GFR 30 to 59 mL/minute/1.73 m2) and little, if any, in patients with mild, chronic renal disease (GFR 60 to 89 mL/minute/1.73 m2). NSF, a potentially fatal disease, affects the skin, muscle, and internal organs. All patients should be screened for renal dysfunction prior to administration; estimate GFR through laboratory testing in patients at risk for chronic renal disease (diabetes, chronic hypertension, age >60 years). In patients at risk of NSF, do not exceed the recommended dosage and allow sufficient time (ie, several half-lives) for elimination prior to readministration (avoidance of readministration is preferred). In patients receiving hemodialysis, consider prompt initiation of hemodialysis following administration.
Disease-related concerns:
• Hemolytic disease: Use with caution in patients with hemolytic disease; transient increase in serum iron have occurred.
• Hepatic impairment: Use with caution in patients with hepatic impairment; transient increases in total bilirubin have occurred.
• Renal impairment: Use with caution in patients with renal impairment. Dose-dependent worsening of renal function or acute renal failure has occurred in patients with renal insufficiency, generally within 48 hours following administration. Evaluate renal function in patients with renal impairment prior to use; consider follow-up monitoring.
• Seizures: Use with caution in patients with seizure disorders; may decrease seizure threshold.
• Sickle cell disease: Use with caution in sickle cell disease; may promote sickling in patients homozygous for sickle cell disease.
Other warnings/precautions:
• Scan interpretation: Use caution when interpreting a contrast-enhanced scan in the absence of a companion unenhanced noncontrast MRI.
Not available in the United States.
Yes
Solution (Magnevist Intravenous)
469.01 mg/mL (per mL): $5.04
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Intravenous:
Magnevist: 469.01 mg/mL (10 mL, 15 mL, 20 mL) [contains meglumine, pentetic acid (dtpa)]
Parenteral: IV: Administer at 10 mL/minute or as a bolus at a rate not to exceed 10 mL per 15 seconds. Complete imaging procedure within 1 hour of injection. Following administration, flush line with NS 5 mL.
Vesicant; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation. If extravasation occurs, stop infusion immediately and disconnect; remove needle/cannula; elevate extremity. Aspiration of extravasated contrast media is not recommended (Ref). Information conflicts regarding the use of hyaluronidase; the American College of Radiology (ACR) Manual on Contrast Media does not recommend hyaluronidase in the management of contrast media extravasation (Ref); other sources suggest its utility in extravasation management (Ref) (see Management of Drug Extravasations for more details).
IV: Administer at a rate of 10 mL per minute or as a bolus at a rate of 10 mL per 15 seconds. Complete imaging procedure within 1 hour of injection. Following administration, flush line with NS 5 mL.
Vesicant; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation.
Extravasation management: If extravasation occurs, stop infusion immediately and disconnect; remove needle/cannula; elevate extremity. Aspiration of extravasated contrast media is not recommended (Ref). Information conflicts regarding the use of hyaluronidase; the American College of Radiology (ACR) Manual on Contrast Media does not recommend hyaluronidase in the management of contrast media extravasation (Ref); other sources suggest its utility in extravasation management for inoperable cases with compartment syndrome (Ref).
If using hyaluronidase: Intradermal or SUBQ: Dose varies based on the size of infiltration; inject a total of 5 to 250 units (~100 mL contrast reabsorbed per 15 units of hyaluronidase) around the site of extravasation (Ref).
Store at 15°C to 30°C (59°F to 86°F). Protect from light. After opening, vial remains stable for 24 hours at ≤30°C (86°F); discard thereafter.
Canadian labeling: Contrast medium for MRI in infants, children, and adults to visualize CNS lesions with abnormal vascularity in the brain, spine, and associated tissues; extracranial/extraspinal lesions with abnormal vascularity in the head and neck; and body lesions with abnormal vascularity.
ALERT: Canadian Boxed Warning: Health Canada-approved labeling includes a boxed warning. See "Warnings/Precautions" section for a concise summary of this information. For verbatim wording of the boxed warning, consult the product labeling.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program
There are no known significant interactions.
Gadopentetate dimeglumine crosses the placenta (Marcos 1997).
Pregnant patients may be at increased risk for gadolinium retention. Use of gadolinium-based contrast agents in pregnancy is controversial and should be limited. A gadolinium-based contrast agent with MRI may be considered for use in pregnancy if it will significantly improve diagnostic performance and is expected to improve fetal or maternal outcome (ACOG 723 2017). In addition, use should only be considered if information needed from the MRI study cannot be acquired without using a contrast agent and cannot be deferred until after delivery. Agents with a low risk for development of nephrogenic systemic fibrosis should be used at the lowest effective dose (ACR 2023).
Monitor renal function (prior to administration); signs of hypersensitivity (during and for several hours after procedure); injection site for extravasation; short- and long-term monitoring of signs and symptoms of nephrogenic systemic fibrosis (eg, burning, itching, swelling, hardening and/or tightening of skin, joint stiffness, deep hip or rib bone pain, muscle weakness, limited range of motion, and/or yellowed/raised spots on whites of eye).
Exposure to an external magnetic field induces a large local magnetic field in gadopentetate exposed tissues. This local magnetism disrupts water protons in the vicinity, resulting in a change in proton density and spin characteristics, which can be detected by the imaging device.
Distribution: Vd: 266 ± 43 mL/kg; does not cross intact blood-brain barrier; distribution half-life: 0.2 ± 0.13 hours.
Half-life elimination: 1.6 ± 0.13 hours.
CrCl ≥60 mL/minute: 2.6 ± 1.2 hours.
CrCl 30 to <60 mL/minute: 4.2 ± 2 hours
CrCl <30 mL/minute: 10.8 ± 6.9 hours.
OR
Mild to moderate kidney impairment: 3 to 4 hours.
Severe kidney impairment: ~11 hours.
Excretion: Urine (~91% as gadopentetate within 24 hours).
