Serious adverse events have not been reported in healthy subjects with dosages up to 5 times the normal clinical dose (maximum dose investigated).
High doses of manganese can have negative inotropic and vasodilatory effects as well as effects on heart rhythm and conduction because of calcium antagonism.
Treatment of an overdose should be symptomatic and directed towards the support of vital functions. There is no antidote to this contrast medium.
Mangafodipir and its metabolites are dialysable whereas manganese is not dialysable because of protein binding (see also Pharmacokinetic properties under CLINICAL PHARMACOLOGY).
Hypersensitivity to the active substance or to any of the excipients.
Pregnancy and lactation.
Phaeochromocytoma.
Severely reduced liver function (Child - Pugh class C), especially severe obstructive
hepatobiliary disease.
Severely reduced renal function.
Most of the adverse reactions reported were transient and of mild intensity. Those most commonly reported were: feeling of warmth/flushing, headache and nausea. In clinical trials with Teslascan (mangafodipir) , adverse reactions have been reported with the following frequencies given in the table below (very common ≥ 1/10; common ( ≥ 1/100 to < 1/10); uncommon ( ≥ 1/1,000 to < 1/100); rare ( ≥ 1/10,000 to < 1/1,000); very rare < 1/10,000, not known (cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
| System Organ Class | Adverse Reactions | Frequency |
| Immune system disorders | Hypersensitivity reactions (such as skin reactions, rhinitis, pharyngitis)
Anaphylactic/anaphylactoid reactions |
Uncommon Not known |
| Nervous system disorders | Headache Dizziness, paraesthesia, transient perverted sensation of taste |
Common Uncommon |
| Eye disorders | Visual disturbance | Very rare |
| Cardiac disorders | Palpitation | Uncommon |
| Vascular disorders | Hypertension | Rare |
| Gastrointestinal disorders | Nausea Abdominal pain, diarrhoea, vomiting Flatulence |
Common Uncommon Very rare |
| General disorders and administration site conditions | Flushing, feeling hot Fever, injection site pain Chest pain |
Common Uncommon Very rare |
Mangafodipir can cause transient increases of bilirubin and liver transaminases and transient decreases in plasma zinc.
The frequency of mild and moderate, non-serious adverse reactions, mainly transient warmth and flushing, is likely to increase when TESLASCAN (mangafodipir) is administered at the faster rate advised (4–6 ml/min).
This medicinal product is for diagnostic use only.
Contrast medium for diagnostic Magnetic Resonance Imaging (MRI) for the detection of lesions of the liver suspected to be due to metastatic disease or hepatocellular carcinomas. As an adjunct to MRI to aid in the investigation of focal pancreatic lesions.
Ascorbic acid
Sodium chloride
Sodium hydroxide and/or hydrochloric acid (pH adjustment)
Water for injections.
This medicinal product must not be mixed with other medicinal products.
A separate cannula should be used.
Shelf lifeUnopened: 2 years.
Once opened the product should be used immediately.
Keep the vial in the outer carton in order to protect from light.
The product should be used immediately after first opening (see above).
Nature and contents of container50 ml clear, colourless vials (type 1 glass). The containers are closed with rubber stoppers and sealed with aluminium caps with polypropylene lids.
TESLASCAN (mangafodipir) is supplied in packs of 1 x 50 ml and 10 x 50 ml vials.
Not all pack sizes may be marketed
Special precautions for disposal and other handlingTESLASCAN (mangafodipir) vials should be visually inspected for particulate matter and for the integrity of the container prior to use. Vials are intended for single use only; any unused portions must be discarded.
The required volume to be given to the patient should be determined and any excess volume should be withdrawn from the vial before infusion.
Connective tubing may be flushed with physiological saline (sodium chloride 9 mg/ml (0.9%)), to ensure complete administration of the contrast medium.
Marketing Authorisation Holder:
GE Healthcare AS
Nycoveien 1-2
P.O. Box 4220 Nydalen
NO-0401 OSLO, Norway
Marketing Authorisation Numbers:
EU/1/97/040/001
EU/1/97/040/002
Date Of First Authorisation/Renewal Of The Authorisation:
Date of first authorisation: 22.05.1997
Date of latest renewal: 22.05.2007
Date Of Revision Of The Text: 22.05.2007
Included as part of the PRECAUTIONS section
PRECAUTIONS Special warnings and precautions for useRarely, hypersensitivity reactions (urticaria and other possible allergic phenomena) or anaphylactoid reactions may occur. Familiarity with the practice and technique of resuscitation and treatment of anaphylaxis is essential. Appropriate medicinal products and instruments should be readily available.
Care should be exercised in patients with severe cardiac disease and in patients with injuries of the blood brain barrier and severe cerebral disease.
The fact that long term parenteral nutrition with manganese supplementation can cause manganese accumulation in the basal ganglia should be considered when administering TESLASCAN (mangafodipir) to patients on such treatment.
This medicinal product contains 5.5 mmol (126 mg) sodium per normal dose of 35 ml. To be taken into consideration by patients on a controlled sodium diet.
Pregnancy and lactation PregnancyThe safety of TESLASCAN (mangafodipir) in human pregnancy has not been established. TESLASCAN (mangafodipir) must not be used during pregnancy (see the CONTRAINDICATIONS section).
Prior to administration of TESLASCAN (mangafodipir) to women of child bearing potential, pregnancy should be excluded.
Pre-clinical studies in rats have established teratogenic effects when TESLASCAN (mangafodipir) was given repeatedly during major organogenesis. TESLASCAN (mangafodipir) causes foetotoxicity and embryotoxicity in rabbits. TESLASCAN (mangafodipir) is not teratogenic in rabbits. TESLASCAN (mangafodipir) has no effect on male or female fertility in rats.
LactationThe degree of excretion into human breast milk is not known. Breast-feeding should be discontinued from the time of administration and should not be recommenced until 14 days after administration of TESLASCAN (mangafodipir).
Effects on ability to drive and use machinesNo studies on the effects on the ability to drive and use machines have been performed.
The medicinal product is for single intravenous use only as repeated dosing has not been studied. It should be administered as an intravenous infusion at the rate of 2-3 ml/min for liver imaging and at a rate of 4-6 ml/min for imaging of the pancreas.
Near maximal enhancement of the normal liver and pancreas parenchyma is generally observed 15-20 minutes from the start of administration and lasts for approximately 4 hours.
At the clinical dose the contrast agent has no T2-effect, and pre- and post- T2-weighted images are equivalent. The clinical use of TESLASCAN (mangafodipir) has been investigated at field strengths from 0.5 to 2.0 Tesla.
Dosage for adultsThe recommended dose is 0.5 ml/kg bodyweight (5 μmol/kg bodyweight). This corresponds to a dose of 35 ml for a 70 kg person. Above 100 kg body weight, 50 ml is usually sufficient to provide a diagnostically adequate contrast effect.
Dosage for elderly 4
Pharmacokinetics in the elderly has not been investigated. However, clinical studies to date do not suggest that a dose adjustment is required.
Children and adolescentsSafety and efficacy in patients below the age of 18 have not been documented i.e. children (2-11 years) and adolescents (12-18 years).
Most of the adverse reactions reported were transient and of mild intensity. Those most commonly reported were: feeling of warmth/flushing, headache and nausea. In clinical trials with Teslascan (mangafodipir) , adverse reactions have been reported with the following frequencies given in the table below (very common ≥ 1/10; common ( ≥ 1/100 to < 1/10); uncommon ( ≥ 1/1,000 to < 1/100); rare ( ≥ 1/10,000 to < 1/1,000); very rare < 1/10,000, not known (cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
| System Organ Class | Adverse Reactions | Frequency |
| Immune system disorders | Hypersensitivity reactions (such as skin reactions, rhinitis, pharyngitis)
Anaphylactic/anaphylactoid reactions |
Uncommon Not known |
| Nervous system disorders | Headache Dizziness, paraesthesia, transient perverted sensation of taste |
Common Uncommon |
| Eye disorders | Visual disturbance | Very rare |
| Cardiac disorders | Palpitation | Uncommon |
| Vascular disorders | Hypertension | Rare |
| Gastrointestinal disorders | Nausea Abdominal pain, diarrhoea, vomiting Flatulence |
Common Uncommon Very rare |
| General disorders and administration site conditions | Flushing, feeling hot Fever, injection site pain Chest pain |
Common Uncommon Very rare |
Mangafodipir can cause transient increases of bilirubin and liver transaminases and transient decreases in plasma zinc.
The frequency of mild and moderate, non-serious adverse reactions, mainly transient warmth and flushing, is likely to increase when TESLASCAN (mangafodipir) is administered at the faster rate advised (4–6 ml/min).
DRUG INTERACTIONS Interaction with other medicinal products and other forms of interactionNo interaction studies have been performed.
