Version May 2024
Blood pool imaging: IV: 10 to 20 mCi (370 to 740 MBq) for an average 70 kg patient.
GI bleeding: IV: 10 to 20 mCi (370 to 740 MBq) for an average 70 kg patient.
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.
There are no adverse reactions listed in the manufacturer's labeling.
There are no contraindications listed in the manufacturer's labeling.
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. Note: Contents of kit are not radioactive; however, adequate shielding is required after addition of radioactive material.
Other warnings/precautions:
• Appropriate use: Contents of the kit are for use in preparation of the labeled red blood cells and not for direct administration to the patient. For autologous use only; the labeled red blood cells must only be reinjected into the same patient from whom the blood was drawn. Apply universal precautions for blood product handling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit, Intravenous:
Ultratag RBC: Contents to be combined with patient blood sample and sodium pertechnetate Tc99m injection solution (not included)
IV: Collect 1 to 3 mL blood sample from patient; follow manufacturer’s instruction for transfer and reaction. For autologous use only; reinfuse only into the same patient from which the blood sample was drawn. Administer within 30 minutes (or as soon as possible) of preparation.
Radiopharmaceutical; use appropriate precautions for handling and disposal.
Diagnostic imaging: Blood pool imaging agent (including cardiac first pass and gated equilibrium imaging); detection of sites of GI bleeding
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-labeled red blood cells cross the placenta (Bural 2011; Martin 1990); the amount of technetium Tc 99m that can be detected in fetal tissue 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 present in breast milk.
Available guidelines recommend lactating women interrupt breastfeeding for a period of 6 to 12 hours after the injection of technetium Tc 99m-labeled red blood cells (ABM [Mitchell 2019]; IAEA 2018). During the period of breastfeeding interruption, the manufacturer recommends substituting formula for breast milk. Alternatively, women can pump and store breast milk prior to the procedure, which can be bottle-fed (Harding 1995).
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).
Tc 99m-labeled autologous red blood cells are reinjected into the patient for gamma scintigraphic imaging.
Distribution: Vd: ~5.6% of body weight
Half-life elimination: ~29 hours
Excretion: Urine (~25%)
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