Blood pool imaging: IV: Stannous gluceptate complex: 0.03 mL/kg (16 micrograms Sn/kg) administered 10 to 30 minutes prior to 15 to 25 mCi (555 to 925 MBq) of sodium pertechnetate Tc 99m.
Brain imaging: IV (based on 70 kg patient): 15 to 20 mCi (555 to 740 MBq).
Renal imaging: IV (based on 70 kg patient): 10 to 15 mCi (370 to 555 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 and incidences are derived from product labeling unless otherwise specified.
<1%, postmarketing and/or case reports: Allergic dermatitis, dyspnea, erythema, flushing, hypersensitivity, nausea, pruritus, skin rash, vomiting
Hypersensitivity to technetium Tc 99m gluceptate or any component of the formulation.
Disease-related concerns:
• Renal impairment: Patients with renal disease may have delayed elimination, therefore decreasing quality of images.
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: Blood pool imaging: Ensure patient is in stable cardiac condition prior to administering. Have resuscitative equipment readily available. If an imaging procedure with sodium pertechnetate Tc 99m is anticipated, that exam should be conducted prior to the use of stannous gluceptate or >1 week after the use of sodium pertechnetate Tc 99m.
• Appropriate use: Brain/kidney imaging: Patients should be adequately hydrated prior to and after dosing; instruct patients to void frequently for 4 to 6 hours following administration to decrease radiation exposure to the bladder.
Not available in the US
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, Intravenous:
Draximage Gluceptate: Calcium gluceptate 25 mg per vial (5s) [to be combined with sodium pertechnetate Tc99m injection solution (not included)]
IV: For IV administration. Radiopharmaceutical; use appropriate precautions for handling and disposal.
Blood pool imaging: Administer stannous gluceptate 10 to 30 minutes prior to injection of sodium pertechnetate Tc 99m by direct venipuncture; avoid heparinized catheter systems.
Brain/kidney imaging: Patients should be adequately hydrated prior to dosing; instruct patients to void frequently for 4 to 6 hours following administration to decrease radiation exposure to the bladder. Imaging may begin immediately after injection.
Imaging agent: Brain imaging agent used for evaluation of brain perfusion; kidney imaging agent used for evaluation of renal perfusion; cardiac blood pool imaging agent.
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).
Technetium Tc 99m is excreted into breast milk.
In a case report, a breastfeeding mother was administered technetium Tc 99m glucoheptonate 550 mBq IV 1 month after delivery. Peak activity in the breast milk was detected 3 hours after the injection and the calculated effective dose (0.085 mSv) was low enough that an interruption of breastfeeding would not have been necessary (Mountford 1987).
Although the manufacturer recommends that breastfeeding be discontinued, available guidelines do not require interruption of breastfeeding following maternal use of technetium Tc 99m gluceptate for renal perfusion studies (ABM [Mitchell 2019]).
Elective diagnostic procedures should be delayed until breastfeeding has stopped (SNM 2010). Women who are breastfeeding and caring for individuals undergoing nuclear medicine procedures do not need any additional precautions (ABM [Mitchell 2019]).
Excretion of technetium Tc 99m into colostrum is widely variable and information is limited; therefore, recommendations related to early breastfeeding cannot be made (Mountford 1989; Rubow 1994).
Radioactive diagnostic agent which decays by isomeric transition to emit a photon that can be detected by imaging.
Blood pool imaging: Excretion: Urine (~28% after 24 hours); delayed in patients with ischemic heart disease.
Brain/kidney imaging: Excretion: Urine (~70% after 24 hours); delayed in patients with renal impairment.
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