Magnegite

The drug with the trade name Magnegita (gadopentetic acid) is classified as a radiopaque agent belonging to a group of pharmacotherapeutic substances with the general code ATC V08CA01 (use in nuclear magnetic resonance imaging). One milliliter of solution contains the active substances: gadopentetate dimeglumine about 500 mg, gadolinium about 80 mg. Excipients: meglumine, pentetic acid and water. The injection solution is used for diagnostic purposes, namely:

• during magnetic resonance imaging of the spinal cord and brain;
• to detect stenosis (arterial angiography);
• in tomography of body parts - the neck area, heart, liver, kidneys and genitourinary organs, mammary glands, pancreas, as well as the musculoskeletal system.

Ampoules with a colorless, transparent solution (yellowish, yellow-brown and yellow-greenish shades are acceptable) Magnegita from the pharmacy network are sold only with a prescription.

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Indications Magnegite

Paramagnetic contrast agents are indispensable tools in magnetic resonance imaging. Indications for use of Magnegit:

1. Examination of the spinal cord and brain:

• for the purpose of differentiating tumor processes, including small ones that are difficult to diagnose;
• recurrence of tumor formations in the postoperative state or as a result of radiation therapy, determination of the presence of metastasis sites;
• diagnosis of various tumor foci (with small pituitary adenoma, ependymoma, hemangioblastoma);
• if it is necessary to confirm or refute the diagnosis of meningioma, a tumor process with infiltration into nearby cells (such as glioma), or acoustic neuroma;
• recognition of intra- and extramedullary formations;
• improving the quality of images of intracranial lesions of non-cerebral origin. Magnegita is used as an additional substance in spinal MRI;
• when it is necessary to assess the degree of proliferation of intramedullary tumor processes;
• obtaining data on the volume of large spinal cord formations.

2. Magnetic resonance imaging with increased image quality and contrast (diagnosis of the facial part of the skull, neck areas, sternum, peritoneum, pelvic organs, mammary glands and musculoskeletal system), which makes it possible to judge the state of the vascular bed (excluding the coronary arteries):

• differentiation of foci of inflammation and tumor development, vascular pathologies;
• assessment of the condition of the kidneys and their functioning;
• in order to identify the spread of a pathogenic source;
• the likelihood of recurrence of intervertebral disc displacement after surgery;
• if it is necessary to diagnose internal structural changes in pathology;
• to assist the diagnostician who evaluates the postoperative condition of the tumor and scar tissue;
• to determine the blood supply to tissues during normal functioning and in the disease stage.

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Release form

The drug Magnegita solution 10, 15, 20, 30 or 100 ml, packaged in glass bottles, sealed with a rubber stopper and covered with an aluminum cap on top, equipped with a plastic flip-off lid. The cardboard packaging includes one or ten bottles, sold together with instructions for use in the state language.

The product is available in a volume of up to 20 ml in glass syringes placed in containers.

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Pharmacodynamics

Contrasting agents, such as Magnegit solution, help to increase the accuracy of differentiation of pathological conditions using magnetic resonance scanning. This became possible due to the presence of a gadolinium complex with pentetic acid, which has seven unpaired electrons, in the pharmacological substance. Stable paramagnetic action is manifested by means of di-N-methylglucamine salt of gadopentetate. By means of the gadolinium ion, which increases the signal intensity during tomography, a clear image of the tissues being examined is achieved.

Pharmacodynamics of Magnegite is based on the properties of DTPA – diethylenetriaminepentaacetic acid, which reduces the time of spin-lattice relaxation of excited atomic nuclei. The effectiveness of paramagnetic action or the ability to relax is based on the effect of even a small concentration of the substance on the period of spin-lattice relaxation of plasma protons. The paramagnetic ion of gadolinium creates a strong relationship with DTPA, which is distinguished by high stability.

Gadopentetate has high hydrophilic properties, which minimizes the possibility of anaphylactic reaction. The drug does not interact with plasma protein, does not affect enzymatic activity, which determines its good tolerability and insignificance of general and local side effects.

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Pharmacokinetics

Magnegite solution is characterized by rapid spread in the extracellular space. The ability to detect tumor processes, subacute infarctions, abscesses is determined by the property of the contrast agent to concentrate in the area with altered tissue - scars, cysts, vascular network pathologies. At the same time, the drug is not concentrated in healthy areas. The pharmacological substance does not violate the boundaries of the intact hematoencephalic (associated with the brain, regulates metabolic processes between the central nervous system and the bloodstream) and histohematic (blood and tissue fluid) barriers. Gadopentetate acid partially passes through the placental barrier, however, it is immediately excreted. The pharmacokinetics of Magnegite indicate that the solution has an insignificant connection with plasma protein and is not metabolized.

Gadopentetate dimeglumine is excreted in its original form through the glomerular filter located in the kidneys, a small volume (up to 1%) of the solution is excreted with feces and breast milk. The half-life is 90 minutes.

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Dosing and administration

The use of the drug Magnegita is permitted only in hospital conditions under the supervision of appropriately qualified personnel who have undergone special training and are aware of all possible negative consequences after the injection.

The method of administration and dosage depend on the type of study and the age of the patient:

• for newborns and infants up to one year of age, the appropriateness of using a contrast solution is determined by a doctor;
• administration to children under 2 years of age is permitted at a dose of up to 0.2 ml/kg;
• upon reaching 2 years of age, the dosage can be increased to a maximum of 0.4 ml/kg;
• for adults, the amount of solution varies from 0.2 to 0.4 ml/kg and can be administered sequentially in two portions if the development of a pathological lesion is in question;
• sometimes, to increase the accuracy of the study, the figure is increased to 0.6 ml/kg (in case of metastases and relapses of tumor processes, as well as for the purpose of studying blood vessels);
• People with kidney problems are allowed a maximum of 0.2 ml/kg of gadopentetic acid if the benefit from tomography outweighs the risk to the patient (hemodialysis is required after the scan).

It is important to understand that data on the use of Magnegit in whole-body tomography in children under two years of age is very limited.

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Use Magnegite during pregnancy

It should be noted that there is insufficient information on the use and action of Magnegit during pregnancy. Experimental data obtained by testing the drug on animals indicate a negative effect on the reproductive organs.

The use of Magnegit during pregnancy is possible if the need for tomographic examination outweighs the possible risks. Having weighed the potential threat to the developing baby in the womb, the doctor gives a conclusion on the possibility of scanning and the necessary control measures.

Partial excretion of gadopentetate dimeglumine through milk during lactation is noted. The percentage of the drug does not exceed four hundredths of the initial dosage, which usually does not pose a danger to the baby. In any case, the administration of the solution should be carried out under the supervision of the attending physician, since there are side effects from the central nervous system, cardiovascular system in the mother and baby. For this reason, it is not recommended to continue feeding for 12 hours after MRI.

Contraindications

MRI with contrast agent requires compliance with the following rules:

• The patients being studied should not have neuro- and cardiac pacemakers, insulin pumps, or ferromagnetic implants;
• the use of the drug Magnegita is possible only intravenously and once, necessarily in a hospital setting;
• the last meal is allowed no less than two hours before the scan;
• the injection of the solution should be done in a lying position, then the patient must be continuously monitored for half an hour (it is during this period that all possible side effects develop);
• individuals with increased excitability are prescribed sedatives before tomography to prevent the risk of negative effects;
• The manipulation room must be supplied with medications and special equipment that helps qualified personnel minimize and avoid side effects (in cases of respiratory arrest, convulsions, etc.).

Contraindications to the use of Magnegita concern individual intolerance to one of the components of the pharmacological solution, as well as patients with severe renal dysfunction. Hypersensitivity is manifested by reactions from the dermis, respiratory organs and cardiovascular system. Negative phenomena, as a rule, occur within half an hour after the introduction of Magnegita, less often delayed pathological conditions occur. Therefore, people prone to allergic reactions, having a history of bronchial asthma, represent a special risk group. Magnegita is used with caution in patients with epilepsy due to the risk of occurrence and intensification of seizures. All persons, especially over 60 years old, are recommended to check the kidney function before the introduction of a contrast agent.

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Side effects Magnegite

As clinical practice shows, side effects are short-term and moderate. In order to prevent the development of life-threatening conditions, it is important to consider the possible side effects of Magnegit:

• general type - pain in the head, back, chest, joints, feeling of weakness and malaise, fever, severe sweating, fainting;
• locally detected - edema, inflammatory reactions, pain syndrome, necrosis, phlebitis or thrombophlebitis;
• digestive disorders – abdominal pain, loose stools, nausea, vomiting, taste disturbances, increased salivation, changes in liver fermentation and quantitative increase in bilirubin in the blood;
• allergic reactions – conjunctivitis, discharge from the nose and eyes, coughing and sneezing, swelling, anaphylactic shock, rash or redness on the skin, itching, broncho- and laryngospasm;
• cardiovascular complications – arrhythmia and hypotension are detected, tachycardia and even cardiac arrest are possible;
• effects on the central and peripheral nervous system – headache, dizziness, pre-fainting state, overexcitement, loss of consciousness, problems with the speech apparatus, vision and hearing, increased weakness and drowsiness, convulsions, asthenic manifestations, coma;
• impact on breathing – lack of oxygen, shortness of breath, cough of varying intensity, pulmonary edema, respiratory arrest;
• from the urinary system - involuntary urination, frequent urination, increased creatinine levels in the presence of kidney pathology, renal failure.

The use of Magnegit may affect the presence of iron and bilirubin in the blood serum.

Overdose

Cases of Magnegita use indicate that overdose has not been detected in clinical practice. Only negative symptoms caused by the hyperosmoticity of the contrast solution are possible:

• osmotic diuresis;
• increased pressure in the pulmonary artery;
• dehydration;
• local pain syndrome in the vascular bed;
• activation of blood and plasma circulation, characterized by an increase in their volume.

In the event of acute renal failure, extrarenal blood purification (hemodialysis) is required.

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Interactions with other drugs

Data on the interaction of Magnegita with other drugs are not provided, since compatibility testing has not been conducted. It is undesirable to use Magnegita in parallel with other medicinal substances. It is known that the use of beta-blockers by patients against the background of the introduction of gadopentetic acid can cause a hypersensitivity reaction. The contrast agent contains an insignificant amount of pentetic acid, which affects the blood test when detecting the quantitative content of iron (the indicators may be underestimated within 24 hours after tomography).

After completing the MRI, it is recommended to refrain from driving a vehicle for 24 hours and avoid working with dangerous machinery due to possible side effects observed in the central nervous or cardiovascular systems, as well as due to a decrease in reaction speed.

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Storage conditions

Store Magnegite injection solution in its original packaging at a temperature range of 5-25 degrees. Do not expose the medicine to direct sunlight. Magnegite storage conditions include a dark, cool place where children cannot reach it.

It is important to remember safety precautions:

• used only intravenously;
• the substance is placed into the syringe immediately before the manipulation;
• Excess unused gadopentetate acid should not be used.

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Shelf life

The shelf life of the radiopaque substance is 3 years, provided that the packaging is intact and the necessary storage requirements are met. It is prohibited to use the pharmacological agent Magnegita after the expiration date, if the glass bottle or closing cap is damaged.