Precautions are necessary when examining these patients (e. g. monitoring of the patient) and the equipment and medicinal products needed for the rapid treatment of possible convulsions should be available.  Renal impairment and liver transplant patients There have been reports of nephrogenic systemic fibrosis (NSF) associated with use of some gadolinium-containing contrast agents in patients with severe renal impairment (GFR < 30ml/ min/ 1.73m2), and in those who have had or are undergoing liver transplantation.