Indications for ADREVIEW:
As adjunct to other diagnostic tests, for the detection of primary or metastatic pheochromocytoma or neuroblastoma. For scintigraphic assessment of sympathetic innervation of the myocardium by measurement of the heart to mediastinum (H/M) ratio of radioactivity uptake in patients with NYHA class II or class III heart failure and left ventricular ejection fraction (LVEF) ≤35%.
Limitations of Use:
In CHF patients: not established for selecting a therapeutic intervention or for monitoring response to therapy. Not established for using the H/M ratio to identify a patient with high mortality risk.
Adults and Children:
Administer thyroid blockade medications at least 1hr prior to dose; individualize. Give by IV inj over 1–2mins. <16yrs (<70kg): calculate dose based on body weight (see full labeling); (≥70kg): 10mCi (370MBq). ≥16yrs: 10mCi (370MBq).
Should only be used by trained and experienced physicians in the safe use and handling of radionuclides to minimize radiation exposure. Ensure adequate hydration; encourage frequent voiding for first 48hrs post-administration. Allergy to iodine. Conditions that affect the sympathetic nervous system (eg, Parkinson's disease, multiple system atrophy): risk of imaging errors. Increased risk for thyroid neoplasia without use of blocking agents. Monitor pulse, BP prior to and intermittently for 30mins post-administration. Have emergency equipment/medications readily available to treat cardiac, hypertension, anaphylactic, or hypersensitivity reactions. Severe renal impairment. Neonates/infants: monitor for gasping syndrome. Elderly: assess renal function prior to administration. Pregnancy. Nursing mothers: interrupt and pump/discard breastmilk for at least 6 days after administration.
Radioactive diagnostic agent.
Risk of imaging errors with concomitant antihypertensives that deplete norepinephrine stores or inhibit reuptake (eg, reserpine, labetalol), antidepressants that inhibit norepinephrine transfer function (eg, amitriptyline and derivatives, imipramine and derivatives, SSRIs), sympathomimetic amines (eg, phenylephrine, phenylpropanolamine, pseudoephedrine, ephedrine), cocaine; discontinue for at least 5 half-lives prior to administration if medically feasible and monitor.
Dizziness, rash, pruritus, flushing, headache, inj site hemorrhage; hypersensitivity reactions.
Generic Drug Availability:
Single-dose vial (5mL)—1