Adreview Generic Name & Formulations
Iobenguane I 123 74MBq/mL (2mCi/mL); soln for IV inj; contains benzyl alcohol.
Radioactive diagnostic agent.
Single-dose vial (5mL)—1
Mechanism of Action
Iobenguane is taken up by the norepinephrine transporter in adrenergic nerve terminals and stored in the presynaptic storage vesicles. Iobenguane accumulates in adrenergically innervated tissues such as the adrenal medulla, salivary glands, heart, liver, spleen and lungs as well as tumors derived from the neural crest. By labeling iobenguane with the isotope iodine 123, it is possible to obtain scintigraphic images of the organs and tissues in which the radiopharmaceutical accumulates.
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.
Adreview Dosage and Administration
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).
Adreview Boxed Warnings
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-inj. Allergy to iodine. Have resuscitation equipment/medications readily available. 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. 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.
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.
Adreview Adverse Reactions
Dizziness, rash, pruritus, flushing, headache, inj site hemorrhage; hypersensitivity reactions.
Adreview Clinical Trials
Adreview Patient Counseling