Version July 2025
Dosage guidance:
Clinical considerations: Administer carbidopa 150 mg orally 60 to 120 minutes prior to fluorodopa F18 injection. If clinically appropriate, discontinue medications for the treatment of Parkinson disease (eg, dopamine agonists, dopamine reuptake inhibitors, dopamine releasing agents, peripheral catechol-O-methyltransferase inhibitors, monoamine oxidase inhibitors) 12 hours prior to fluorodopa F18 injection. Start imaging ⁓80 minutes after fluorodopa F18 administration (with a 9 second CT scan for attenuation correction) followed by 3D PET scan from 80 to 100 minutes after administration.
Diagnostic imaging:
Parkinson disease: IV: 5 mCi (185 MBq).
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 are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.
Postmarketing: Nervous system: Pain
There are no contraindications listed in the manufacturer's labeling.
Concerns related to adverse effects:
• Malignancy: Fluorodopa F18 injection administration contributes to the patient's overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to the patient and health care providers.
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.
Concurrent drug therapy issues:
• Parkinson therapies: Interference by Parkinson therapies (eg, dopamine agonists, dopamine reuptake inhibitors, dopamine releasing agents, peripheral catechol-O-methyltransferase inhibitors, monoamine oxidase inhibitors) with a fluorodopa F18 image has not been established; however, according to the product labeling, if use of these drugs can be safely suspended, discontinue use 12 hours before administration of fluorodopa F18.
Other warnings/precautions:
• Experienced staff: Images should only be interpreted by specially trained personnel.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Intravenous:
15.5-308.2 MBq/mL (0.42 to 8.33 mCi/mL) (1 ea)
Availability may be limited to certain institutions.
IV: Administer IV over 1 minute. Hydrate (with water only; consume no other food or drink) 4 hours prior to fluorodopa F18 administration; continue hydration after study completion. Patient should void 70 minutes after fluorodopa F18 administration (ie, immediately before imaging) and as frequently thereafter as possible for the next 12 hours.
Radiopharmaceutical; use appropriate precautions for handling and disposal. Waterproof gloves should be worn and effective shielding should be used during handling and administration.
Diagnostic imaging: For use with positron emission tomography (PET) imaging to visualize dopaminergic nerve terminals in the striatum for the evaluation of adults with suspected Parkinsonian syndromes. Use as an adjunct to other diagnostic evaluations.
Radiopharmaceutical: Use appropriate precaution for handling, disposal, and minimizing exposure to patients and health care personnel. Use under supervision of experienced personnel. Should be stored in compliance with the appropriate regulations of the applicable regulatory authority.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Anti-Parkinson Agents (Dopamine Agonist): Coadministration of Anti-Parkinson Agents (Dopamine Agonist) and Fluorodopa F18 may alter diagnostic results. Management: Discontinue medications used to treat Parkinson disease, including dopamine agonists, 12 hours prior to fluorodopa F 18 administration if these medications can be safely withheld. Risk D: Consider Therapy Modification
Anti-Parkinson Agents (Monoamine Oxidase Inhibitor): Coadministration of Anti-Parkinson Agents (Monoamine Oxidase Inhibitor) and Fluorodopa F18 may alter diagnostic results. Management: Discontinue medications used to treat Parkinson disease, including MAO inhibitors, 12 hours prior to fluorodopa F 18 administration if these medications can be safely withheld. Risk D: Consider Therapy Modification
CNS Stimulants: Coadministration of CNS Stimulants and Fluorodopa F18 may alter diagnostic results. Management: Discontinue medications used to treat Parkinson disease, including dopamine reuptake inhibitors and dopamine releasing agents, such as psychostimulants, 12 hours prior to fluorodopa F 18 administration if these medications can be safely withheld. Risk D: Consider Therapy Modification
COMT Inhibitors: Coadministration of COMT Inhibitors and Fluorodopa F18 may alter diagnostic results. Management: Discontinue medications used to treat Parkinson disease, including peripheral COMT inhibitors, 12 hours prior to fluorodopa F 18 administration if these medications can be safely withheld. Risk D: Consider Therapy Modification
Animal reproduction studies have not been conducted.
All radiopharmaceuticals have the potential to cause fetal harm.
It is not known if fluorodopa F18 is present in breast milk.
According to the manufacturer, the decision to breastfeed should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother. To decrease potential exposure to the breastfed infant, the manufacturer recommends to express and discard breastmilk for 24 hours after administration of fluorodopa F18.
Fluorodopa F18 is a radioactive diagnostic agent used in positron emission tomography (PET) imaging that is decarboxylated by amino acid decarboxylase to fluorodopamine (FDA) F18 in dopaminergic nerve terminals in the brain and stored in presynaptic vesicles. The accumulation of F18 FDA in the striatum is visually detected in PET.
Onset: Optimal PET imaging is achieved between 75 to 90 minutes after administration.
Metabolism: Decarboxylated by aromatic amino acid decarboxylase in the striatum to fluorodopamine F18. Fluorodopamine F18 is metabolized via monoamine oxidase to yield [18F] 6-fluoro-3,4-dihydroxyphenylacetic acid (18FDOPAC) and subsequently by COMT to yield [18F]6-fluorohomovanillic acid (18FHVA).
Half-life elimination: Biologic: ⁓1 to 3 hours.
Excretion: Urine (80%); urine radioactivity peaks ~30 minutes post injection. Note: The radiation absorbed dose to the bladder wall is reduced by emptying the bladder just before scanning.
Clearance: Cleared from blood and tissue within 24 hours.
