Neuroendocrine tumor imaging:
Planar imaging: IV: 3 mCi (111 MBq).
Single photon emission computed tomograph (SPECT) imaging: IV: 6 mCi (222 MBq).
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Neuroendocrine tumor imaging: IV: 0.14 mCi/kg (5 MBq/kg).
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.
<1%:
Cardiovascular: Bradycardia, flushing, hypotension
Dermatologic: Diaphoresis
Gastrointestinal: Nausea
Hematologic & oncologic: Decreased hematocrit, decreased hemoglobin
Hepatic: Abnormal transaminase
Nervous system: Dizziness, headache
Neuromuscular & skeletal: Arthralgia, asthenia
Miscellaneous: Fever
Postmarketing: Hypersensitivity: Anaphylaxis, angioedema, hypersensitivity reaction
There are no contraindications listed in the manufacturer’s labeling.
Concerns related to adverse effects:
• Glucose regulation: May cause severe hypoglycemia in patients with insulinomas; use with caution. Administer glucose before and during indium In-111 pentetreotide administration.
• Hypersensitivity reactions: Hypersensitivity, including rash, pruritus, and rarely anaphylaxis-related reactions and angioedema, have occurred; cases usually resolved without intervention or with symptomatic management.
Concurrent drug therapy issues:
• Octreotide acetate: Sensitivity of scintigraphy may be reduced with concurrent octreotide; consider temporarily withdrawing octreotide prior to scintigraphy.
Disease-related concerns:
• Renal impairment: Use with caution in patients with renal impairment.
Special handling:
• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and health care personnel. Use under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, [preservative free]:
Octreoscan:
Injection, powder for reconstitution: Pentetreotide 10 mcg
Injection, solution: Indium In-111 chloride 111 MBq (3.0 mCi) per 1 mL (1.1 mL)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, [preservative free]:
Octreoscan:
Injection, powder for reconstitution: Pentetreotide 10 mcg
Injection, solution: Indium In-111 chloride 111 MBq (3.0 mCi) per 1 mL (1.1 mL)
IV: For IV administration. Patient should be well-hydrated before and after administration. To minimize bladder exposure, patients should increase fluid intake and void frequently for 24 hours post administration. Laxatives should be used before and for 48 hours after receiving indium In-111 pentetreotide.
Radiopharmaceutical; use appropriate precautions for handling and disposal.
Radiopharmaceutical; use appropriate precautions for handling and disposal. When handling and administering, follow appropriate safety measures to minimize radiation exposure during administration; use waterproof gloves and effective shielding, including syringe shields.
IV: For IV administration only. May be administered undiluted or diluted with NS prior to administration. Patient should be well-hydrated before and after administration. To minimize bladder exposure, patients should increase fluid intake and void frequently for 24 hours post administration (Ref). Laxatives should be used before and for 48 hours after receiving indium In-111 pentetreotide.
Neuroendocrine tumor imaging: Scintigraphic localization of primary and metastatic neuroendocrine tumors with somatostatin receptors
Note: Due to greater sensitivity and decreased radiation dose, imaging agents targeting somatostatin receptors labeled with Gallium 68 (eg, Gallium Ga 68 Dotatate) are preferred over somatostatin receptor scintigraphy (Indium In-111 Pentetreotide) (Hope 2018; Sadowski 2016).
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.
Animal studies have not been conducted. Radiopharmaceuticals have the potential to cause fetal harm. Use during pregnancy only if clearly needed.
In one patient report, only 0.025% of the administered dose was excreted in breast milk, which would have resulted in an infant dose of 82 mrem (0.82 mSv) if breast-feeding had not been interrupted. This amount is so low that interruption of breast-feeding is not necessary; however, the radiation exposure to the infant from the mother while being held in close contact may be sufficiently high that interruption of breast-feeding may be recommended in order to limit the time of close contact (Rubow 2000).
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