Dotarem

Dotarem is the brand name for gadoterate meglumine, a gadolinium-based contrast agent (GBCA) used in magnetic resonance imaging (MRI). It is a macrocyclic, ionic chelate that increases the signal of tissues on T1-weighted MRI by shortening the relaxation time of nearby water protons. After intravenous administration, gadoterate distributes in the extracellular fluid and is predominantly eliminated by the kidneys.

Indications for Dotarem include contrast-enhanced MRI to delineate normal from abnormal tissue and to visualize vascular structures. It is used in central nervous system imaging to highlight lesions such as tumors, inflammatory or infectious processes, and in other body regions to improve lesion conspicuity and, where appropriate, in MR angiography protocols.

Administration and dosing: Dotarem is given by intravenous injection as a bolus or slow infusion. The typical dose is 0.1 mmol per kilogram of body weight (concentration 0.5 mmol/mL). Administration is followed by a saline flush. Dosing may be adjusted for pediatric patients and should consider renal function; repeated injections should account for cumulative exposure and renal status.

Safety and precautions: Adverse events are generally uncommon and may include headache, nausea, dizziness, or a warm sensation at the injection site. Hypersensitivity reactions are possible but rare. Nephrogenic systemic fibrosis (NSF) is associated with gadolinium agents in patients with severe renal impairment; macrocyclic agents like gadoterate meglumine have a lower NSF risk, but renal function should still be assessed before administration. Caution is advised with pregnancy and in lactation, and in patients with known hypersensitivity to gadoterate meglumine or its components. As with all GBCAs, use the lowest effective dose and reassess the need for repeat exposure.