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Indium In-111 pentetreotide: Drug information

Indium In-111 pentetreotide: Drug information
(For additional information see "Indium In-111 pentetreotide: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Octreoscan
Brand Names: Canada
  • Octreoscan
Pharmacologic Category
  • Radiopharmaceutical
Dosing: Adult
Neuroendocrine tumor imaging

Neuroendocrine tumor imaging:

Planar imaging: IV: 3 mCi (111 MBq).

Single photon emission computed tomograph (SPECT) imaging: IV: 6 mCi (222 MBq).

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric
Neuroendocrine tumor imaging

Neuroendocrine tumor imaging: IV: 0.14 mCi/kg (5 MBq/kg).

Adverse Reactions

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

Contraindications

There are no contraindications listed in the manufacturer’s labeling.

Warnings/Precautions

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.

Dosage Forms: US

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)

Dosage Forms: Canada

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)

Administration: Adult

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.

Administration: Pediatric

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.

Use: Labeled Indications

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).

Medication Safety Issues
Other safety concerns:

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.

Pregnancy Considerations

Animal studies have not been conducted. Radiopharmaceuticals have the potential to cause fetal harm. Use during pregnancy only if clearly needed.

Breastfeeding Considerations

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).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (CH) Switzerland: Octreoscan;
  • (CO) Colombia: Octreoscan;
  • (FR) France: Octreoscan;
  • (IT) Italy: Octreoscan;
  • (JP) Japan: Octreoscan;
  • (KR) Korea, Republic of: Octreoscan;
  • (RU) Russian Federation: Octreotide, 111In
  1. Balon HR, Goldsmith SJ, Siegel BA, et al, "Society of nuclear Medicine Procedure Guideline for Somatostatin Receptor Scintigraphy with IN-111 Pentetreotide," J Nucl Med, 2001, 42(7):1134-8. Available at http://interactive.snm.org/docs/pg_ch27_0403.pdf. Last accessed April 27, 2010. [PubMed 11438641]
  2. Hope TA, Bergsland EK, Bozkurt MF, et al. Appropriate use criteria for somatostatin receptor PET imaging in neuroendocrine tumors. J Nucl Med. 2018;59(1):66-74. [PubMed 29025982]
  3. OctreoScan (indium In-111 pentetreotide) [prescribing information]. Maryland Heights, MO: Curium US LLC; February 2022.
  4. Rubow SM and Ellman A, "Indium-111 Scintigraphy and Breastfeeding," Eur J Nucl Med, 2000, 27(8):1057.
  5. Sadowski SM, Neychev V, Millo C, et al. Prospective study of 68Ga-DOTATATE positron emission tomography/computed tomography for detecting gastro-entero-pancreatic neuroendocrine tumors and unknown primary sites. J Clin Oncol. 2016;34(6):588-596. [PubMed 26712231]
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