Table 1.

Structure, Stability, Estimated Number of Global Injections, Number of Confounded and Unconfounded Reports of NSF, Classification by the European Medicines Agency, US Food and Drug Administration (FDA) and American College of Radiology, and Health Canada Guidelines for Patients With Severe Chronic Kidney Disease and Acute Kidney Injury Among Currently Approved Gadolinium-Based Contrast Agents for Clinical Use in Canada.

Agent	Structure	Stability (log Keq)	Estimated number of global administrations (millions)	Number of unconfounded cases of NSF	Number of confounded cases of NSF	EMA Classification	FDA and ACR Classification	Health Canada position
Gadodiamide (Omniscan, GE Healthcare)	Linear nonionic	16.9	47	438	90	High risk	I	Absolutely contraindicated
Gadopentetate dimeglumine (Magnevist, Bayer Pharmaceuticals)	Linear ionic	22.5	95	135	276	High risk	I	Absolutely contraindicated
Gadoversetamide (Optimark, Guerbet Group)	Linear nonionic	16.6	0.8	7	11	High risk	I	Absolutely contraindicated
Gadobenate dimeglumine (MultiHance, Bracco Pharmaceuticals)	Linear ionic	22.6	30	0	32	Medium risk	II	May be used with extreme caution
Gadoxetate disodium (Primovist, Bayer Pharmaceuticals)	Linear nonionic	23.5	4.3	0	0	Medium risk	III	May be used with extreme caution
Gadoteridol (Prohance, Bracco Pharmaceuticals)	Macrocyclic nonionic	23.8	22	1 or 2	37	Low Risk	II	May be used with extreme caution
Gadoterate meglumine (Dotarem, Guerbet Group)	Macrocyclic ionic	25.8	65	0 or 1	7	Low risk	II	NAa
Gadobutrol (Gadovist, Bayer Pharmaceuticals)	Macrocyclic nonionic	21.8	5.7	3	8	Low risk	II	May be used with extreme caution

Note. NSF = nephrogenic systemic fibrosis; EMA = European Medicines Agency; FDA = Food and Drug Administration; ACR = American College of Radiology.

^aGadoteric acid was not available for clinical use in Canada at time of most recent Health Canada update on NSF.⁹