Магнитно-резонансная томография (МРТ) головного и спинного мозга у взрослых и детей старше 4 недель. Контрастирование всего тела у взрослых и детей старше 6 месяцев. МР ангиография у взрослых. МРТ сердца для оценки ишемической болезни сердца (ИБС) посредством визуализации в условиях перфузии миокарда (при нагрузке/в покое и отсроченное исследование ...
Гиперчувствительность к активному компоненту или любому вспомогательному веществу. Гадодиамид противопоказан пациентам с тяжелыми нарушениями функции почек (клиренс креатинина менее 30 мл/мин/1,73 м2), пациентам, перенесшим или ожидающим пересадку печени и новорожденным детям в возрасте до 4 недель.
Магнитно-резонансная томография (МРТ) головного и спинного мозга у взрослых и детей старше 4 недель. Контрастирование всего тела у взрослых и детей старше 6 месяцев. МР ангиография у взрослых. МРТ сердца для оценки ишемической болезни сердца (ИБС) посредством визуализации в условиях перфузии миокарда (при нагрузке/в покое и отсроченное исследование при контрастном усилении), для обнаружения и локализации ишемической болезни сердца (ИБС) и различения участков ишемии и инфаркта у пациентов с известной или предполагаемой ИБС.
Противопоказания
Гиперчувствительность к активному компоненту или любому вспомогательному веществу. Гадодиамид противопоказан пациентам с тяжелыми нарушениями функции почек (клиренс креатинина менее 30 мл/мин/1,73 м2), пациентам, перенесшим или ожидающим пересадку печени и новорожденным детям в возрасте до 4 недель.
Применение при беременности и в период грудного вскармливания
Отсутствует опыт применения Омнискана у людей во время беременности. Не следует использовать препарат для обследования беременных женщин, за исключением тех случаев, когда проведение МРТ с контрастным усилением представляется крайне необходимым и предполагаемая польза для матери от его применения превышает потенциальный риск для плода. Препарат не оказывал влияния на фертильность или репродукцию у крыс или в тератологических исследованиях на крысах и кроликах в дозах, нетоксичных для матери. Неизвестно, выводится ли гадодиамид с грудным молоком у женщин. Грудное вскармливание следует прекратить перед введением препарата и не возобновлять как минимум на протяжении 24 часов после исследования.
Способ применения и дозы
Препарат предназначен для внутривенного введения. Как и все препараты для парентерального введения, Омнискан перед введением следует проверить (визуально) на предмет отсутствия механических включений, изменений цвета и нарушений целостности упаковки. Специальная подготовка пациента не требуется. Омнискан набирают в шприц непосредственно перед использованием. Взрослым и детям требуемую дозу следует вводить в форме однократной внутривенной инъекции. При МРТ сердца выполняют две инъекции для изучения перфузии при нагрузке и в покое. При выполнении внутривенной болюсной инъекции для МРТ сердца рекомендуется использовать подходящий инъектор со скоростью подачи контрастного вещества до 8 мл/сек. Для того, чтобы обеспечить введение полной дозы контрастного вещества, капельницу можно промыть 0,9% раствором натрия хлорида. При внутривенном струйном введении однократно шприцом через катетер. Омнискан должен быть набран в шприц непосредственно перед использованием. За 2 часа до процедуры пациент должен прекратить прием пищи. При введении препарата больной должен находиться в горизонтальном положении. В течение 30 мин после окончания процедуры осуществляют врачебный контроль за пациентом, т.к. большинство побочных реакций возникает именно в этот период. У детей до 1 года и пациентов с заболеваниями почек средней степени тяжести (скорость клубочковой фильтрации 30-59 мл/мин/1.73 м2) применение препарата должно быть оценено с точки зрения риск-польза и ограничено введением стандартной дозы (0,1 ммоль/кг массы тела). Повторное введение препарата не должно проводиться ранее чем через 7 дней.
Побочное действие
Нарушения со стороны иммунной системы: нечасто - аллергические реакции кожи и слизистых оболочек, повышенная чувствительность, редко - анафилактический шок/анафилактоидные реакции, которые могут быть первыми признаками начинающегося шока. Поздние побочные реакции могут возникать в период от нескольких часов до нескольких дней после введения препарата. Нарушения психики: редко - тревожность, частота неизвестна - психические нарушения. Нарушения со стороны нервной системы: часто - головная боль, нечасто - головокружение, парестезия, кратковременное извращение вкусовых ощущений, редко - судороги (вплоть до развития эпилептического статуса), тремор, сонливость, кратковременное извращение обоняния, частота неизвестна - атаксия, нарушение координации движений, потеря сознания (вплоть до развития глубокой комы), шум в ушах. Нарушения со стороны органа зрения: редко - нарушение зрения. Нарушения со стороны сердца: частота неизвестна - тахикардия. Нарушения со стороны сосудов: нечасто - покраснение кожи. Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: редко - диспноэ, кашель, частота неизвестна - чихание, першение в горле, бронхоспазм, одышка. Нарушения со стороны желудочно-кишечного тракта: часто - тошнота, нечасто - рвота, диарея, частота неизвестна: снижение аппетита, отрыжка, боль в животе. Нарушения со стороны кожи и подкожных тканей: нечасто - зуд, редко - крапивница, сыпь, отек, включая отек лица и ангионевротический отек, частота неизвестна - нефрогенный системный фиброз у пациентов с тяжелыми нарушениями функции почек. Нарушения со стороны скелетно-мышечной и соединительной ткани: редко - артралгия, частота неизвестна - миалгия. Нарушения со стороны крови и лимфатической системы: частота неизвестна - бессимптомное снижение содержания сывороточного железа (в сроки от 8 до 48 ч после введения препарата). Нарушения со стороны почек и мочевыводящих путей: редко - у пациентов с предшествующим серьезным нарушением функции почек возможно развитие острой почечной недостаточности, частота неизвестна - повышение уровня сывороточного креатинина. Общие расстройства и нарушения в месте введения: часто - локальная болезненность или ощущение тепла, прохлады или распирания в месте введения, редко - лихорадка, озноб, боль в груди, частота неизвестна - повышенное потоотделение, ощущения жара, гиперемия кожи лица. Если любые из указанных в инструкции побочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты не указанные в инструкции, сообщите об этом врачу.
Передозировка
Симптомы: возможно усиление проявлений описанных побочных эффектов. Лечение симптоматическое. Контрастное вещество удаляется путем гемодиализа (у пациентов с нарушенной функцией почек и получивших большие дозы).
Особые указания
Возможно развитие побочных реакций, в том числе анафилактического шока во время введения препарата, особенно у пациентов с гиперчувствительностью в анамнезе. В кабинете необходимо создать все условия для проведения немедленной, интенсивной терапии. Перед каждым применением контрастного вещества следует получить необходимую информацию о пациенте, включая важные лабораторные показатели (например, концентрацию креатинина в сыворотке крови, электрокардиограмма, аллергия в анамнезе, наличие беременности). Перед исследованием у пациента следует устранить нарушения водно-электролитного баланса и обеспечить достаточное поступление жидкости и электролитов. Особенно у пациентов с множественной миеломой, сахарным диабетом, полиурией или подагрой, а также новорожденных, грудных детей и детей раннего возраста, пожилых пациентов. Отсутствие контрастного усиления не является однозначным свидетельством отсутствия патологии, т.к. некоторые виды новообразований или неконтрастные бляшки при атеросклерозе не контрастируются. Наличие или отсутствие контрастного усиления может быть использовано для дифференциального диагноза. Каждый флакон или одноразовый шприц предназначен для использования только у одного пациента. Неиспользованные остатки препарата должны быть уничтожены. При введении других препаратов необходимо использовать отдельные шприц и иглу. Пациентам, испытывающим страх ожидания перед процедурой, необходима премедикация успокаивающими средствами. Омнискан может оказывать влияние на результаты измерения концентрации кальция в плазме при использовании колометрических комплексных методик часто применяемых в больницах. Поэтому не рекомендуется использование этих методик в первые 12-24 часов после введения препарата Омнискан. Если подобные исследования необходимы, рекомендуется использовать другие методы. Необходимо учитывать возможность развития побочных реакций, включая серьезные угрожающие жизни анафилактоидные реакции. Случаи развития НСФ у пациентов со среднетяжелой почечной недостаточностью неизвестны. У пациентов страдающих эпилепсией или поражениями головного мозга во время исследования увеличивается риск возникновения судорог. При проведении исследований таких пациентов (например, мониторное наблюдение) необходимо предусмотреть наличие оборудования и лекарственных средств для лечения возможных судорог. У детей до 1 года и пациентов с заболеваниями почек средней степени тяжести (скорость клубочковой фильтрации 30-59 мл/мин/1,73 м) применение препарата должно быть оценено с точки зрения риск-польза и ограничено введением стандартной дозы (0,1 ммоль/кг массы тела) и интервал между введением препарата должен составлять не менее 7 дней. Осторожность так же должна соблюдаться при применении препарата Омнискан у пациентов с гепаторенальным синдромом.
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Предназначено для диагностических целей."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Магнитно-резонансная томография (МРТ) головного и спинного мозга у взрослых и детей старше 4 недель. Контрастирование всего тела у взрослых и детей старше 6 месяцев. МР ангиография у взрослых. МРТ сердца для оценки ишемической болезни сердца (ИБС) посредством визуализации в условиях перфузии миокарда (при нагрузке/в покое и отсроченное исследование при контрастном усилении), для обнаружения и локализации ишемической болезни сердца (ИБС) и различения участков ишемии и инфаркта у пациентов с известной или предполагаемой ИБС."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к активному компоненту или любому вспомогательному веществу. Гадодиамид противопоказан пациентам с тяжелыми нарушениями функции почек (клиренс креатинина менее 30 мл/мин/1,73 м2), пациентам, перенесшим или ожидающим пересадку печени и новорожденным детям в возрасте до 4 недель."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Отсутствует опыт применения Омнискана у людей во время беременности. Не следует использовать препарат для обследования беременных женщин, за исключением тех случаев, когда проведение МРТ с контрастным усилением представляется крайне необходимым и предполагаемая польза для матери от его применения превышает потенциальный риск для плода. Препарат не оказывал влияния на фертильность или репродукцию у крыс или в тератологических исследованиях на крысах и кроликах в дозах, нетоксичных для матери. Неизвестно, выводится ли гадодиамид с грудным молоком у женщин. Грудное вскармливание следует прекратить перед введением препарата и не возобновлять как минимум на протяжении 24 часов после исследования."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат предназначен для внутривенного введения. Как и все препараты для парентерального введения, Омнискан перед введением следует проверить (визуально) на предмет отсутствия механических включений, изменений цвета и нарушений целостности упаковки. Специальная подготовка пациента не требуется. Омнискан набирают в шприц непосредственно перед использованием. Взрослым и детям требуемую дозу следует вводить в форме однократной внутривенной инъекции. При МРТ сердца выполняют две инъекции для изучения перфузии при нагрузке и в покое. При выполнении внутривенной болюсной инъекции для МРТ сердца рекомендуется использовать подходящий инъектор со скоростью подачи контрастного вещества до 8 мл/сек. Для того, чтобы обеспечить введение полной дозы контрастного вещества, капельницу можно промыть 0,9% раствором натрия хлорида. При внутривенном струйном введении однократно шприцом через катетер. Омнискан должен быть набран в шприц непосредственно перед использованием. За 2 часа до процедуры пациент должен прекратить прием пищи. При введении препарата больной должен находиться в горизонтальном положении. В течение 30 мин после окончания процедуры осуществляют врачебный контроль за пациентом, т.к. большинство побочных реакций возникает именно в этот период. У детей до 1 года и пациентов с заболеваниями почек средней степени тяжести (скорость клубочковой фильтрации 30-59 мл/мин/1.73 м2) применение препарата должно быть оценено с точки зрения риск-польза и ограничено введением стандартной дозы (0,1 ммоль/кг массы тела). Повторное введение препарата не должно проводиться ранее чем через 7 дней."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы: нечасто - аллергические реакции кожи и слизистых оболочек, повышенная чувствительность, редко - анафилактический шок/анафилактоидные реакции, которые могут быть первыми признаками начинающегося шока. Поздние побочные реакции могут возникать в период от нескольких часов до нескольких дней после введения препарата. Нарушения психики: редко - тревожность, частота неизвестна - психические нарушения. Нарушения со стороны нервной системы: часто - головная боль, нечасто - головокружение, парестезия, кратковременное извращение вкусовых ощущений, редко - судороги (вплоть до развития эпилептического статуса), тремор, сонливость, кратковременное извращение обоняния, частота неизвестна - атаксия, нарушение координации движений, потеря сознания (вплоть до развития глубокой комы), шум в ушах. Нарушения со стороны органа зрения: редко - нарушение зрения. Нарушения со стороны сердца: частота неизвестна - тахикардия. Нарушения со стороны сосудов: нечасто - покраснение кожи. Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: редко - диспноэ, кашель, частота неизвестна - чихание, першение в горле, бронхоспазм, одышка. Нарушения со стороны желудочно-кишечного тракта: часто - тошнота, нечасто - рвота, диарея, частота неизвестна: снижение аппетита, отрыжка, боль в животе. Нарушения со стороны кожи и подкожных тканей: нечасто - зуд, редко - крапивница, сыпь, отек, включая отек лица и ангионевротический отек, частота неизвестна - нефрогенный системный фиброз у пациентов с тяжелыми нарушениями функции почек. Нарушения со стороны скелетно-мышечной и соединительной ткани: редко - артралгия, частота неизвестна - миалгия. Нарушения со стороны крови и лимфатической системы: частота неизвестна - бессимптомное снижение содержания сывороточного железа (в сроки от 8 до 48 ч после введения препарата). Нарушения со стороны почек и мочевыводящих путей: редко - у пациентов с предшествующим серьезным нарушением функции почек возможно развитие острой почечной недостаточности, частота неизвестна - повышение уровня сывороточного креатинина. Общие расстройства и нарушения в месте введения: часто - локальная болезненность или ощущение тепла, прохлады или распирания в месте введения, редко - лихорадка, озноб, боль в груди, частота неизвестна - повышенное потоотделение, ощущения жара, гиперемия кожи лица. Если любые из указанных в инструкции побочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты не указанные в инструкции, сообщите об этом врачу."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: возможно усиление проявлений описанных побочных эффектов. Лечение симптоматическое. Контрастное вещество удаляется путем гемодиализа (у пациентов с нарушенной функцией почек и получивших большие дозы)."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Возможно развитие побочных реакций, в том числе анафилактического шока во время введения препарата, особенно у пациентов с гиперчувствительностью в анамнезе. В кабинете необходимо создать все условия для проведения немедленной, интенсивной терапии. Перед каждым применением контрастного вещества следует получить необходимую информацию о пациенте, включая важные лабораторные показатели (например, концентрацию креатинина в сыворотке крови, электрокардиограмма, аллергия в анамнезе, наличие беременности). Перед исследованием у пациента следует устранить нарушения водно-электролитного баланса и обеспечить достаточное поступление жидкости и электролитов. Особенно у пациентов с множественной миеломой, сахарным диабетом, полиурией или подагрой, а также новорожденных, грудных детей и детей раннего возраста, пожилых пациентов. Отсутствие контрастного усиления не является однозначным свидетельством отсутствия патологии, т.к. некоторые виды новообразований или неконтрастные бляшки при атеросклерозе не контрастируются. Наличие или отсутствие контрастного усиления может быть использовано для дифференциального диагноза. Каждый флакон или одноразовый шприц предназначен для использования только у одного пациента. Неиспользованные остатки препарата должны быть уничтожены. При введении других препаратов необходимо использовать отдельные шприц и иглу. Пациентам, испытывающим страх ожидания перед процедурой, необходима премедикация успокаивающими средствами. Омнискан может оказывать влияние на результаты измерения концентрации кальция в плазме при использовании колометрических комплексных методик часто применяемых в больницах. Поэтому не рекомендуется использование этих методик в первые 12-24 часов после введения препарата Омнискан. Если подобные исследования необходимы, рекомендуется использовать другие методы. Необходимо учитывать возможность развития побочных реакций, включая серьезные угрожающие жизни анафилактоидные реакции. Случаи развития НСФ у пациентов со среднетяжелой почечной недостаточностью неизвестны. У пациентов страдающих эпилепсией или поражениями головного мозга во время исследования увеличивается риск возникновения судорог. При проведении исследований таких пациентов (например, мониторное наблюдение) необходимо предусмотреть наличие оборудования и лекарственных средств для лечения возможных судорог. 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