Version May 2024
Renal imaging: Term neonates: IV: 1.85 MBq/kg (0.05 mCi/kg); begin imaging 1 to 4 hours after administration.
Renal imaging: Infants, Children, and Adolescents: IV: 1.85 MBq/kg (0.05 mCi/kg); begin imaging 1 to 4 hours after administration.
There are no dosage adjustments provided in the manufacturer's labeling; patients with severely reduced eGFR should have imaging delayed up to 6 to 24 hours to obtain satisfactory images.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Technetium Tc-99m succimer: Drug information")
Renal imaging: IV: 2 to 6 mCi (74 to 222 MBq).
There are no dosage adjustments provided in the manufacturer's labeling; use with caution. Note: For patients with severely reduced eGFR, delaying imaging to between 6 to 24 hours after administration may improve image quality.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Postmarketing:
Cardiovascular: Syncope
Gastrointestinal: Nausea
Hypersensitivity: Hypersensitivity reaction
Miscellaneous: Fever
There are no contraindications listed in the manufacturer's labeling.
Concerns related to adverse effects:
• Hypersensitivity reactions: Hypersensitivity (eg, erythema, pruritus, rash, urticaria) occurring within 2 hours to several hours after administration has been reported. Appropriate medication and equipment should be readily available during and after administration.
Disease-related concerns:
• Renal impairment: Patients with renal disease may have delayed elimination, therefore decreasing quality of images; consider delaying imaging 6 to 24 hours.
Special handling:
• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and healthcare personnel. Use only under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority. Note: Contents of kit are not radioactive; however, adequate shielding is required after addition of radioactive material.
Other warnings/precautions:
• Appropriate use: Patients should be adequately hydrated prior to dosing; instruct patients to void frequently following administration to decrease radiation exposure to the bladder.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, Intravenous:
Nephroscan: Succimer 1 mg per vial (5s) [to be combined with sodium pertechnetate Tc99m injection solution (not included)]
No
Parenteral: IV: Administer by slow IV injection. Radiopharmaceutical; use appropriate precautions for handling and disposal. Ensure adequate hydration prior to administration and encourage patient to drink fluids following administration. To minimize bladder exposure, patients should void frequently following administration.
IV: For IV administration only. Position patient in the prone or supine position; begin imaging 1 to 4 hours after administration. For patients with severely reduced eGFR, delaying imaging to between 6 to 24 hours after administration may improve image quality. Ensure adequate hydration prior to administration and encourage patient to drink fluids following administration. To minimize bladder exposure, patients should void frequently following administration.
Radiopharmaceutical; use appropriate precautions for handling and disposal.
Prior to preparation, store kit in original container at 2°C to 8°C (36°F to 46°F); do not freeze. After preparation, store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F) and use within 4 hours; discard unused material. Visually inspect reconstituted material; do not use if evidence of discoloration or foreign matter.
Scintigraphic evaluation of renal parenchymal disorders (FDA approved in all ages).
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.
Pregnancy status should be evaluated prior to use in women of reproductive potential (SNM 2010).
The manufacturer recommends elective studies be conducted during the first 10 days of the menstrual cycle in women of reproductive potential.
Technetium Tc 99m can be detected in fetal tissue; the amount depends upon the specific formulation, route of administration, and stage of pregnancy (Adelstein 1999).
In general, the potential for a radiopharmaceutical to cause fetal harm depends on the dose absorbed by the fetus and the stage of pregnancy. High doses of radiopharmaceuticals used for therapeutic procedures are more likely to result in fetal harm. A medically required diagnostic procedure can usually be modified to decrease fetal risk. Elective diagnostic procedures should be delayed until after delivery (ACR-SPR 2018; Adelstein 1999; ICRP 2000; SNM 2010).
Radioactive diagnostic agent which decays by isomeric transition to emit a photon that can be detected by imaging.
Protein binding: 53% to 70%.
Half-life: Radioactive: 6 hours.
Excretion: Urine (~16% within 2 hours).
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