Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
MultiHance (Bracco)
529 mg/mL in 5 mL, 10 mL, 15 mL and 20 mL vials
Approved indication: magnetic resonance imaging
Magnetic resonance imaging (MRI) can be enhanced by contrast agents. Gadobenate is a gadolinium-based compound that can be used as a contrast agent when imaging the liver or central nervous system.
Patients are given an intravenous dose in proportion to their body weight. Higher doses are used when imaging the central nervous system. Gadobenate is distributed in the plasma and extracellular space and will highlight areas where the blood-brain barrier has broken down. Most of the dose is excreted in the urine within 24 hours.
In a clinical trial involving 205 patients, with suspected lesions in the central nervous system, enhancement with gadobenate or gadodiamide produced similar quality images.1 A comparison with gadopentetate, in patients with suspected liver tumours, found that gadobenate may have an advantage in delayed imaging.2 While these studies assessed the diagnostic information provided by enhanced MRI, they do not say if the imaging made any difference to the patients' treatments.
The adverse effects of gadobenate include hypertension, tachycardia, injection site reactions, nausea and vomiting. Resuscitation equipment is required as patients may have an anaphylactic reaction to gadobenate.
