Note: Dose should be individualized; utilize the lowest dose necessary to obtain images.
Myocardial perfusion: IV:
Planar scintigraphy: 37 to 74 MBq (1 to 2 mCi)
Single-photon emission computed tomography (SPECT): 74 to 111 MBq (2 to 3 mCi)
Parathyroid hyperactivity localization: Planar or SPECT: 75 to 130 MBq (2 to 3.5 mCi).
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Cardiovascular: Cardiac arrhythmia, cerebrovascular accident, flushing, hypotension, myocardial infarction
Central nervous system: Chills
Dermatologic: Diaphoresis, pruritus, skin rash
Gastrointestinal: Mild diarrhea, nausea, vomiting
Hypersensitivity: Anaphylactoid reaction
Neuromuscular & skeletal: Tremor
Ophthalmic: Blurred vision, conjunctivitis
Respiratory: Bronchoconstriction, dyspnea
Miscellaneous: Fever
There are no contraindications listed in the manufacturer’s labeling
Concerns related to adverse effects:
• Cardiovascular events: Arrhythmias, bronchoconstriction, cerebrovascular events, chest pain, ECG abnormalities, hypotension or hypertension, and myocardial infarction (MI) have occurred due to pharmacologic agents used in conjunction with stress imaging. Appropriate measures for monitoring and resuscitation should be available during use.
• Hypersensitivity reactions: Anaphylactoid reactions (flushing, hypotension, pruritus, and diffuse rash) have been reported.
• Local reactions: Local injection site reactions (eg, burning, pain, redness) may occur. Administer intravenously only to avoid local tissue accumulation and irradiation. Ensure proper catheter or needle position prior to and during injection.
Dosage form specific issues:
• Latex: The vial stopper in some products may contain latex.
Special handling:
• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and health care personnel. Use only under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority.
Other warnings/precautions:
• Appropriate use: Administer thallous chloride Tl 201 injection close to calibration time to minimize the effect of higher levels of radionuclidic contaminants present at pre- and post-calibration dates.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Intravenous:
Generic: 37 MBq (1 mCi)/mL (1 ea [DSC]); 74 MBq (2 mCi)/mL (1 ea [DSC])
Yes
Solution (Thallous Chloride TL 201 Intravenous)
2 mci/mL (per each): $162.58 - $731.57
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Intravenous:
Generic: 37 MBq/mL (1 ea)
IV: Radiopharmaceutical; use appropriate precautions for handling and disposal.
For IV administration only. Thallous chloride Tl 201 has a risk for extravasation. Confirm intravenous patency before injection.
Myocardial perfusion imaging: For resting myocardial studies, start imaging 10 to 20 minutes after injection administration; to improve myocardial-to-background ratio images, ensure patients are injected upright (reduces hepatic and gastric thallium Tl-201 concentration) and in the fasting state. For exercise stress testing, administer injection at the start of maximum stress which is sustained for ~30 seconds after injection; start imaging within 10 minutes after administration to obtain maximum target-to-background ratios.
Parathyroid hyperactivity localization: Administer injection before, with, or after a minimal dose of appropriate thyroid imaging agent (eg, sodium pertechnetate Tc 99m or sodium iodide I-123) to enable thyroid subtraction imaging.
Myocardial perfusion imaging: Imaging with planar scintigraphy or single photon emission computed tomography (SPECT) for the diagnosis of coronary artery disease by localization of nonreversible defects (myocardial infarction), and reversible defects (myocardial ischemia) when used in conjunction with exercise or pharmacologic stress.
Parathyroid hyperactivity imaging: Localization of sites of parathyroid hyperactivity pre- and postoperatively in patients with elevated serum calcium and parathyroid hormone levels.
Radiopharmaceutical: Use appropriate precaution for handling, disposal, and minimizing exposure to patients and healthcare personnel. Use under supervision of experienced personnel. Should be stored in original lead container or adequate radiation shield.
None known.
There are no known significant interactions.
Evaluate pregnancy status prior to use in females of reproductive potential.
Animal reproduction studies have not been conducted. Thallous chloride Tl 201 has been shown to cross the placenta.
Thallous chloride Tl 201 is excreted into breast milk. The manufacturer recommends advising patients who continue breast-feeding to express and discard milk for a minimum of 2 weeks after administration. Close contact with infant should be minimized if administered dose would result in an effective dose greater than 1 mSv (0.1 rem) to the infant.
Radioactive diagnostic agent which decays by electron capture to mercury Hg 201 that can be detected by imaging. It is distributed to the myocardium, correlating to regional perfusion.
Distribution: Primarily distributed in the myocardium, thyroid, liver, kidneys and stomach
Half-life elimination: Bi-exponential: Initial radioactive half-life: ~5 minutes; remainder ~40 hours; Biologic half-life: 2.4 days
Time to peak: Myocardium uptake: ~10 minutes
Excretion: Urine (4% to 8% of injected activity within 24 hours); feces
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