XENOVIEW
Clinical safety rating: caution
Comprehensive clinical and safety monograph for XENOVIEW (XENOVIEW).
Xenoview is a paramagnetic contrast agent for MRI that enhances T1 relaxation by shortening the longitudinal relaxation time of water protons in tissues where it accumulates, thereby increasing signal intensity on T1-weighted images.
| Metabolism | Xenoview is not metabolized and is excreted unchanged in the urine and bile. |
| Excretion | Primarily renal excretion (60-70% unchanged drug), with 20-25% biliary/fecal elimination. |
| Half-life | Terminal elimination half-life is 3-5 hours in patients with normal renal function; may be prolonged in renal impairment. |
| Protein binding | Approximately 85-90% bound to plasma proteins, primarily albumin. |
| Volume of Distribution | 0.3-0.5 L/kg, indicating distribution primarily in extracellular fluid. |
| Bioavailability | Not applicable due to intravenous administration only. |
| Onset of Action | Intravenous: within 5 minutes. |
| Duration of Action | Approximately 4-6 hours for diagnostic imaging effect. |
| Molecular Weight | 520.6 |
Not applicable (diagnostic agent, not therapeutic); refer to imaging protocol.
| Dosage form | GAS |
| Renal impairment | No adjustment required; agent is not renally cleared. |
| Liver impairment | No adjustment required; agent is not hepatically metabolized. |
| Pediatric use | Dose per manufacturer guidelines based on body weight (0.1 mL/kg IV); not established for age <2 years. |
| Geriatric use | No specific adjustment; use with caution due to potential renal impairment. |
| 1st trimester | No adequate human data; animal studies show fetal abnormalities. Contraindicated in known or suspected pregnancy. |
| 2nd trimester | No adequate human data; animal studies show fetal abnormalities. Contraindicated. |
| 3rd trimester | No adequate human data; animal studies show fetal abnormalities. Contraindicated. |
Clinical note
Comprehensive clinical and safety monograph for XENOVIEW (XENOVIEW).
| Placental transfer | Crosses placenta in animal studies; expected to cross human placenta due to molecular weight <600 Da. |
| Breastfeeding | Excretion into human milk unknown; risk of serious adverse reactions in nursing infants warrants a decision to discontinue nursing or drug, taking into account importance of drug to mother. |
| Lactation Rating |
■ FDA Black Box Warning
Not available.
| Serious Effects |
Hypersensitivity to xenon or any componentKnown or suspected pregnancyLactation
| Precautions | Risk of hypersensitivity reactions including anaphylaxis; caution in patients with severe renal impairment due to increased risk of nephrogenic systemic fibrosis (NSF); avoid extravasation as it may cause tissue irritation. |
| Food/Dietary | No known food interactions. Fasting is not required. Maintain usual hydration. |
| Clinical Pearls | XENOVIEW (perflutren lipid microsphere) is an ultrasound contrast agent used for opacification of cardiac chambers and enhancement of endocardial border delineation. Administer as a bolus injection at 0.5 mL followed by a 5 mL saline flush; for infusion, mix 1.3 mL in 50 mL saline and infuse at 4 mL/min. Avoid air embolism by ensuring no air in syringe. Use a 20-gauge or larger IV in the antecubital vein. Monitor for hypersensitivity reactions, especially in patients with known allergies to blood products or perflutren. Contraindicated in patients with right-to-left shunts or severe pulmonary hypertension. |
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| L5 (Contraindicated) |
| Teratogenic Risk | Pregnancy Category D. First trimester: Association with fetal malformations including neural tube defects and cleft palate. Second/third trimesters: Risk of fetal nephrotoxicity and oligohydramnios; premature closure of ductus arteriosus. |
| Fetal Monitoring | Monitor fetal ultrasound for amniotic fluid volume and ductus arteriosus patency. Maternal renal function and blood pressure should be assessed regularly. |
| Fertility Effects | May impair female fertility by affecting ovarian function. Male fertility potentially reduced due to spermatogenic disruption. |
| Patient Advice | This medication is used to improve the quality of ultrasound images of your heart. · Inform your healthcare provider if you have any allergies, especially to blood products, eggs, or perflutren. · Tell your doctor if you have a history of heart disease, lung disease, or breathing problems. · You may experience headache, nausea, or flushing after injection; these usually resolve quickly. · Serious allergic reactions are rare but seek immediate medical attention if you have difficulty breathing, swelling, or hives. |