Professional Drug Information > Iobenguane I 123

Iobenguane, Radioiodinated (Systemic—Diagnostic )

VA CLASSIFICATION
Primary: DX201



A commonly used name for iobenguane is
meta-iodobenzylguanidine or mIBG .
Note: For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s).

^†Not commercially available in Canada.

Category:


Diagnostic aid, radioactive (adrenomedullary disorders; neuroendocrine tumors)—

Indications

Note: Bracketed information in the Indications section refers to uses that are not included in U.S. product labeling. In addition, because iobenguane I 123 ( ¹²³I-mIBG) injection is not commercially available in the U.S. or Canada, the bracketed information and the use of the superscript 1 in this monograph reflect the lack of labeled (approved) indications for this product. ^{46}

Accepted

Tumors, adrenal medulla (diagnosis)¹—[¹²³I]- and ¹³¹I-mIBG are used for diagnostic imaging of the adrenal medulla, for the evaluation and localization of intra- and extra-adrenal pheochromocytomas, paragangliomas, and neuroblastomas, as well as for localization of metastatic lesions from these tumors. [¹²³I] - and ¹³¹I-mIBG can also be used for confirmation of diagnosis of pheochromocytoma when catecholamine determination tests are unclear. ^{{01} {03} {04} {05} {06} {08} {09} {11} {14} {17} {20} {22} {23} {33} {34} {35} {37} {38} {45} {46}}

[Tumors, carcinoid (diagnosis)]¹—¹²³I- and ¹³¹I-mIBG scintigraphy are used as screening procedures for suspected carcinoid tumors, especially those of intestinal origin. ^{{02} {05} {23} {27}}

[Hyperplasia, adrenal medulla (diagnosis)]¹—¹²³I- and ¹³¹I-mIBG are used in the evaluation of the adrenal medulla for disorders such as medullary hyperplasia in patients at risk of developing medullary disease (e.g., multiple endocrine neoplasia [MEN type 2, MEN type 3]). ^{{01} {03} {26} {35} {38}}

[Carcinoma, thyroid (diagnosis)]¹—¹²³I- and ¹³¹I-mIBG are used for diagnostic imaging of medullary thyroid carcinoma. ^{{26} {28} {29} {30}}

¹ Not included in Canadian product labeling.

Physical Properties

Nuclear data:

Radionuclide (half-life)	Decay constant	Mode of decay	Principal emissions (keV)	Mean number of emissions/ disintegration
I 123 (13.2 hr)	0.0533 h -1	Electron capture	Gamma (159)	0.83
I 131 (8.08 days)	0.00358 h -1	Beta {45}	Beta (191.6) Gamma (364.5)	0.90 0.81

Pharmacology/Pharmacokinetics

Mechanism of action/Effect:

Iobenguane or meta-iodobenzylguanidine (mIBG) is a physiological analog of the guanidines, such as guanethidine and phenethylguanidine. In adrenergic nerves, guanidines are believed to share the same transport pathway as norepinephrine and to accumulate in, and displace norepinephrine from, intraneuronal storage granules. Similarly, ¹²³I- and ¹³¹I-mIBG are concentrated in, stored in, and released from chromaffin granules. The retention of ¹²³I- and ¹³¹I-mIBG in the adrenal medulla may be a result of their uptake in adrenergic neurons and subsequent sequestration into chromaffin storage granules. Due to their selective uptake mechanism, ¹²³I- and ¹³¹I-mIBG allow specific detection and localization of neuroendocrine tumors and adrenal medullary hyperplasia. The gamma emissions given off by ¹²³I- and ¹³¹I-mIBG allow detection of adrenergic tumors by scintigraphy. ^{{01} {02} {03} {04} {06} {13} {14} {25} {35} {38} {42}}

Medullary thyroid carcinoma—Although the mechanism of ¹²³I- and ¹³¹I-mIBG uptake by medullary thyroid carcinoma (MTC) is not completely understood, it has been found that MTC can produce catecholamines (epinephrine and norepinephrine). Therefore, ¹²³I- and ¹³¹I-mIBG could be taken up and stored in catecholamine vesicles of MTC. ^{28}

Distribution:

After intravenous administration, there is rapid uptake of mIBG mainly in the liver, and in lesser amounts in the lungs, heart, spleen, and salivary glands. Although the uptake in normal adrenal glands is very low, hyperplastic adrenals and tumors such as pheochromocytoma, neuroblastoma, and other tumors with neurosecretory granules have a relatively higher uptake. ^{{25} {35} {36} {42}}

Significant clearance of ¹³¹I-mIBG from the liver and the spleen occurs within 72 hours. ^{{35} {42}}

Time to radioactivity visualization

¹²³I-mIBG—In adrenal medullary tumors: Initial images may be obtained 2 to 3 hours after injection. Images may also be obtained at 18 to 24 hours, and as late as 48 hours post injection. Most pheochromocytomas are visualized at 24 hours. However, due to the short half-life of ¹²³I-mIBG, images may not be possible at times when background (e.g., liver) activity is low and imaging would be optimal. <sup>{35} {44} {42}

131</sup>I-mIBG—In adrenal medullary tumors: 48 hours. Early images at 24 hours after administration of ¹³¹I-mIBG are frequently positive in patients with pheochromocytoma. Decline in liver activity may permit optimal imaging at 48 or 72 hours. ^{{01} {35} {44}}

Radiation dosimetry:
^{25}

Organ	Estimated absorbed radiation dose *
	I 123-mIBG		I 131-mIBG
	mGy/ MBq	rad/ mCi	mGy/ MBq	rad/ mCi
Liver	0.071	0.27	0.83	3.07
Bladder wall	0.070	0.30	0.59	2.18
Spleen	0.020	0.074	0.49	1.81
Salivary glands	0.017	0.063	0.23	0.85
Lungs	0.016	0.059	0.19	0.70
Kidneys	0.014	0.052	0.12	0.44
Adrenals	0.011	0.041	0.17	0.63
Heart	0.011	0.041	0.072	0.26
Pancreas	0.011	0.041	0.10	0.37
Uterus	0.011	0.041	0.080	0.29
Red marrow	0.0092	0.034	0.067	0.25
Large intestine wall (upper)	0.0089	0.033	0.080	0.29
Small intestine	0.0083	0.031	0.074	0.27
Ovaries	0.0080	0.030	0.066	0.24
Stomach wall	0.0078	0.029	0.077	0.28
Large intestine wall (lower)	0.0077	0.028	0.068	0.25
Bone surfaces	0.0076	0.028	0.061	0.23
Breast	0.0062	0.023	0.069	0.25
Testes	0.0054	0.020	0.059	0.22
Thyroid (blocked)†	0.0042	0.016	0.050	0.18
Other tissue	0.0065	0.024	0.062	0.23

Radionuclide and impurities	Effective dose*
	I 123-mIBG		I 131-mIBG
	mSv/ MBq	rem/ mCi	mSv/ MBq	rem/ mCi
I 123	0.018	0.067	—	—
I 124	0.24	0.88	—	—
I 125	0.049	0.18	—	—
I 131	—	—	0.20	0.74

^* For adults; intravenous injection. Data based on the International Commission on Radiological Protection (ICRP) Publication 53—Radiation dose to patients from radiopharmaceuticals.
^† Thyroid dose listed assumes 0% thyroid uptake. However, uptakes ranging from 0.5 to 2% are more typical; consequently the absorbed radiation dose to the thyroid will be many times higher than listed. ^{38}

Elimination:
    Renal; about 40 to 50% of the injected activity is eliminated within 24 hours and about 70 to 90% within 4 days (mainly as unchanged drug with small amounts of ¹²³I- or ¹³¹I-m-iodohippuric acid [ ¹²³I- or ¹³¹I-mIHA], ¹²³I or ¹³¹I iodide, and ¹²³I- or ¹³¹I-m-iodobenzoic acid [ ¹²³I- or ¹³¹I-mIBA]). ^{{32} {35} {42}}


Precautions to Consider

Pregnancy/Reproduction

Pregnancy—
The possibility of pregnancy should be assessed in women of child-bearing potential. Clinical situations exist where the benefit to the patient and fetus, based on information derived from radiopharmaceutical use, outweighs the risks from fetal exposure to radiation. In these situations, the physician should use discretion and reduce the administered activity to the lowest possible amount. ^{{24} {42}}

Breast-feeding

It is not known whether ¹²³I- or ¹³¹I-mIBG is distributed into breast milk. However, this preparation may be contaminated with free radioiodide, which may be distributed into breast milk. It has been recommended that, after administration of a radiopharmaceutical, nursing be resumed only after the infant's ingested effective dose equivalent (EDE) is below 1 mSv (100 mrem). A method to calculate the EDE has been proposed based on the effective half-life of the radionuclide, the activity administered to the mother, the fraction of administered activity ingested by the infant, and the total body effective dose to the newborn infant per unit of activity ingested. According to this method, it has been estimated that, for sodium iodide I 131, the time to reduce the EDE to the infant to below 1 mSv (100 mrem) is approximately 10 weeks after administration of 40 megabecquerels (1.08 millicuries) to the mother. For sodium iodide I 123, the time period required is 3 days with administration of an uncontaminated preparation, 40 days with a preparation contaminated with I 124, and 340 days for a product contaminated with I 125. Because of the difficulty of maintaining the maternal milk supply for such an extended period of time, complete cessation of nursing is usually recommended for all radioiodines, except for uncontaminated I 123. ^{{38} {39} {40} {41} {42}}

Pediatrics

¹²³I- and ¹³¹I-mIBG are used in children. When ¹²³I- or ¹³¹I-mIBG is used in children, the diagnostic benefit should be judged to outweigh the potential risk of radiation. ^{{09} {11} {12} {18} {24} {31} {38}}


Geriatrics


Diagnostic studies performed to date using ¹²³I- or ¹³¹I-mIBG have not demonstrated geriatrics-specific problems that would limit the usefulness of either agent in the elderly.

Drug interactions and/or related problems
The following drug interactions and/or related problems have been selected on the basis of their potential clinical significance (possible mechanism in parentheses where appropriate)—not necessarily inclusive (» = major clinical significance):

» Amphetamines or
» Antidepressants, tricyclic or
» Bretylium or
» Calcium channel blocking agents or
» Cocaine or
» Guanethidine or
» Haloperidol or
» Labetalol or
» Loxapine or
» Metaraminol or
» Phenothiazines or
» Reserpine or
» Sympathomimetics or
» Thiothixene    (these medications may interfere with the uptake of ¹²³I- or ¹³¹I-mIBG; although the ideal time to stop treatment with potential interacting medicines is 1 week prior to administration of ¹²³I- or ¹³¹I-mIBG, the following withdrawal periods are usually recommended based on the individual half-life of each medication: 24 hours for bretylium, cocaine, and metaraminol; 48 hours for amphetamines, calcium channel blocking agents, guanethidine, haloperidol, loxapine, tricyclic antidepressants, phenothiazines, sympathomimetics, and thiothixene; 72 hours for labetalol and reserpine ^{{01} {05} {35} {43}})


Phenoxybenzamine    (although usual doses of phenoxybenzamine do not interfere with ¹²³I- or ¹³¹I-mIBG uptake, when given in high doses necessary to control blood pressure in patients with pheochromocytomas or paragangliomas preparing for surgery, tumor uptake of ¹²³I- or ¹³¹I-mIBG may be suppressed resulting in false-negative studies ^{43})



Side/Adverse Effects
At present, there are no known side/adverse effects associated with the use of diagnostic dosages of ¹²³I- or ¹³¹I-mIBG.



Patient Consultation
As an aid to patient consultation, refer to Advice for the Patient, Radiopharmaceuticals (Diagnostic) .

In providing consultation, consider emphasizing the following selected information (» = major clinical significance):

Description of use
Action in the body: Localization of ¹²³I- or ¹³¹I-mIBG in adrenal medulla allows visualization of hyperactive adrenal medulla and neuroendocrine tumors

Small amounts of radioactivity used in diagnosis; radiation received is low and considered safe

Before having this test
»   Conditions affecting use, especially:

Pregnancy—Risk to fetus from radiation exposure as opposed to benefit derived from study should be considered





Breast-feeding—Not known if distributed into breast milk; however, free radioiodide, if present, may be distributed; cessation of nursing may be recommended to avoid any unnecessary absorbed radiation dose to the infant ^{49}





Use in children—Diagnostic benefit should be judged to outweigh potential risk of radiation

Other medications, especially amphetamines, tricyclic antidepressants, bretylium, calcium channel blocking agents, cocaine, guanethidine, haloperidol, labetalol, loxapine, phenothiazines, reserpine, sympathomimetics, and thiothixene

Preparation for this test
Special preparatory instructions may apply; patient should inquire in advance

Administration of potassium iodide or Lugol"s solution one day before administration of ¹²³I- or ¹³¹I-mIBG and for 6 days after administration to prevent or reduce thyroid uptake of radioiodide contaminant ^{42}


General Dosing Information
Radiopharmaceuticals are to be administered only by or under the supervision of physicians who have had extensive training in the safe use and handling of radioactive materials and who are authorized by the Nuclear Regulatory Commission (NRC) or the appropriate State agency, if required, or, outside the U.S., the appropriate authority. ^{42}

To minimize uptake of radioactive iodine by the thyroid, potassium iodide (SSKI, 60 mg twice a day) or Lugol's solution (1 drop three times a day) may be used, beginning at least 24 hours before and continuing for 6 days after administration of ¹²³I- or ¹³¹I-mIBG. ^{{01} {20} {38} {43}}

Safety considerations for handling this radiopharmaceutical
Improper handling of this radiopharmaceutical may cause radioactive contamination. Guidelines for handling radioactive material have been prepared by scientific, professional, state, federal, and international bodies and are available to the specially qualified and authorized users who have access to radiopharmaceuticals. ^{47}


Parenteral Dosage Forms

Note: Bracketed information in the Indications section refers to uses that are not included in U.S. product labeling. In addition, because ¹²³I-mIBG sulfate injection is not commercially available in the U.S. or Canada, the bracketed information and the use of the superscript 1 in the Dosage Forms section reflect the lack of labeled (approved) indications for this product.
The dosing and strengths of both the ¹²³I- and ¹³¹I-mIBG dosage forms are expressed in terms of the sulfate salt of iobenguane.


IOBENGUANE I 123 INJECTION USP

Usual adult administered activity
[Diagnosis of tumors]¹ or [Diagnosis of medullary disease]¹
Intravenous, 370 megabecquerels (10 millicuries) of ¹²³I-mIBG, with a specific activity of 740 megabecquerels to 1.3 gigabecquerels (20 to 35.6 millicuries) per mg (at time of calibration), administered over a period of fifteen to thirty seconds. ^{{01} {35} {44}}


Usual pediatric administered activity
[Diagnosis of tumors]¹ or [Diagnosis of medullary disease]¹
Children up to 18 years of age: Dosage must be individualized by physician. ^{{42} {44}}


Usual geriatric administered activity
See Usual adult administered activity .

Strength(s) usually available
U.S.—
Not commercially available. In most cases, may be obtained from the University of Michigan Nuclear Pharmacy (UMNP) by physicians who have filed their own Investigational New Drug Application (IND).

Canada—
Not commercially available. In most cases, may be obtained by physicians who have filed their own IND.

Packaging and storage:
Store between -20 and -10 °C (-4 and -14 °F). ^{48}

Note: Caution—Radioactive material.



IOBENGUANE SULFATE I 131 INJECTION

Usual adult administered activity
Diagnosis of tumors¹ or [Diagnosis of medullary disease]¹
Intravenous, 18.5 to 37 megabecquerels (0.5 to 1 millicurie) of ¹³¹I-mIBG with a specific activity of 103.6 to 199 megabecquerels (2.8 to 5.38 millicuries) per mg (at time of calibration), administered over a period of fifteen seconds. ^{{01} {35} {38} {46}}


Usual pediatric administered activity
Diagnosis of tumors¹ or [Diagnosis of medullary disease]¹
Children up to 18 years of age: Dosage must be individualized by physician. ^{01}

Note: In patients 1 year of age or older, the minimum dose necessary for a clinically acceptable study should not be less than 5 megabecquerels (0.135 millicuries). ^{01}



Usual geriatric administered activity
See Usual adult administered activity .

Strength(s) usually available
U.S.—


85.1 megabecquerels (2.3 millicuries) per mL (Rx)[Generic]^{46}

Canada—
Not commercially available. In most cases, may be obtained by physicians who have filed their own IND.

Packaging and storage:
Store between -20 and -10 °C (-4 and -14 °F), unless otherwise specified by manufacturer. ^{{01} {46}}

Note: Caution—Radioactive material.

Revised: 04/25/1995

References

1. Information packets for potential investigators, University of Michigan Nuclear Pharmacy. 1990.
   

2. Adolph JM, Kimmig BN, Georgi P, et al. Carcinoid tumors: CT and I-131 meta-iodobenzylguanidine scintigraphy. Radiology 1987; 164(1): 199-203.
   

3. Beierwaltes WH. Endocrine imaging: part II. J Nucl Med 1991; 32(8): 1634-8.
   

4. Beierwaltes WH. Applications of [I 131]m-iodobenzylguanidine ([I 131]MIBG). Int J Rad Appl Instrum 1987; 14(3): 183-9.
   

5. Bomanji J, Ur E, Mather S, et al. A scintigraphic comparison of iodine 123-metaiodobenzylguanidine and an iodine-labeled somatostatin analog (tyr-3-octreotide) in metastatic carcinoid tumors. J Nucl Med 1992; 33: 1121-4.
   

6. Beierwaltes WH. Update on basic research and clinical experience with metaiodobenzylguanidine. Med Pediatr Oncol 1987; 15(4): 163-9.
   

7. Bomanji J, Levison DA, Flatman WD, et al. Uptake of iodine-123 MIBG by pheochromocytomas, paragangliomas, and neuroblastomas: a histopathological comparison. J Nucl Med 1987; 28(6): 973-8.
   

8. Chan R, Warshawski RS, Scott J, et al. Experience with I-131-metaiodobenzylguanidine (MIBG): a retrospective study. J Can Assoc Radiol 1987; 38(1): 35-9.
   

9. Edeling CJ, Frederiksen PB, Kamper J, et al. Diagnosis of neuroblastoma using metaiodobenzylguanidine. Clin Nucl Med 1987; 12(8): 632-7.
   

10. Ehninger G, Klingebiel T, Kumbier I, et al. Stability and pharmacokinetics of m-[I 131]iodobenzylguanidine in patients. Cancer Res 1987; 47(22): 6147-9.
    

11. Feine U, Müller-Schauenburg W, Treuner J, et al. Metaiodobenzylguanidine (MIBG) labeled with 123 I/131 I in neuroblastoma diagnosis and follow-up treatment with a review of the diagnostic results of the International Workshop of Pediatric Oncology held in Rome, Sept 1986. Med Pediatr Oncol 1987; 15(4): 181-7.
    

12. Hartmann O, Lumbroso J, Lemerle J, et al. Therapeutic use of 131 I-metaiodobenzylguanidine (MIBG) in neuroblastoma: a phase II study in nine patients. Med Pediatr Oncol 1987; 15(4): 205-11.
    

13. Krempe M, Lumbroso J, Mornex R, et al. Use of m-[ ^{13 1}I]iodobenzylguanidine in the treatment of malignant pheochromocytoma. J Clin Endocrinol Metab 1991; 72: 455-61.
    

14. Maisey MN, Britton KE, Gilday DL. Clinical nuclear medicine. 2nd ed. Philadelphia: J.B. Lippincott, 1991: 31.
    

15. McGhie QI, Corbett JR, Akers BS, et al. Regional cardiac adrenergic function using I 123 meta-iodobenzylguanidine tomographic imaging after acute myocardial infarction. Am J Cardiol 1991; 67: 236-42.
    

16. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: data, quantitative analysis and recommendations 1989; Nucl Med Commun 10: 15-27.
    

17. Quint LE, Glazer GM, Francis IR, et al. Pheochromocytoma and paraganglioma: comparison of MR imaging with CT and I 131 MIBG scintigraphy. Radiology 1987; 165(1): 89-93.
    

18. Sanguineti M. Considerations on 131 I-metaiodobenzylguanidine therapy of six children with neuroblastoma. Med Pediatr Oncol 1987; 15(4): 212-5.
    

19. Shulkin BL, Shen SW, Sisson JC, et al. Iodine-131 MIBG scintigraphy of the extremities in metastatic pheochromocytoma and neuroblastoma. J Nucl Med 1987; 28(3): 315-8.
    

20. Ferris J, Caballero O, Verdeguer A, et al. ¹³¹I-MIBG-meta-iodobenzylguanidine ( ¹³¹I-MIBG) in the study of neuroblastoma. An Esp Pediatr 1987; 26(3): 164-70.
    

21. Hladik WB, Saha GB, Study KT. Essentials of nuclear medicine science. Baltimore: Williams & Wilkins, 1987: 206-7.
    

22. Shapiro B, Gross MD. Radiochemistry, biochemistry, and kinetics of ¹³¹I-metaiodobenzylguanidine (MIBG) and ¹²³I-MIBG: clinical implications of the use of ¹²³I-mIBG. Med Pediatr Oncol 1987; 15(4): 170-7.
    

23. Von Moll L, McEwan AJ, Shapiro B, et al. Iodine-131 MIBG scintigraphy of neuroendocrine tumors other than pheochromocytoma and neuroblastoma. J Nucl Med 1987; 28(6): 979-88.
    

24. USP Radiopharmaceuticals Advisory Panel comments as of meeting on 05/08/91.
    

25. Task Group of Committee 2 of the International Commission on Radiological Protection. Annals of the ICRP. ICRP Publication 53—Radiation dose to patients from radiopharmaceuticals. New York: Pergamon Press, 1988: 61.
    

26. Ansari AN, Siegel ME, DeQuattro V, et al. Imaging of medullary thyroid carcinoma and hyperfunctioning adrenal medulla using iodine-131 metaiodobenzylguanidine. J Nucl Med 1986; 27(12): 1858-60.
    

27. Feldman JM, Blinder RA, Lucas KJ, et al. Iodine-131 metaiodobenzylguanidine scintigraphy of carcinoid tumors. J Nucl Med 1986; 27(11): 1691-6.
    

28. Oishi S, Sasaki M, Sato T, et al. Imaging and uptake mechanism of 131 I-meta-iodobenzylguanidine in medullary thyroid carcinoma. Endocrinol Jpn 1986; 33(3): 309-15.
    

29. Coutris G, Talbot JN, Kabla G, et al. Uptake of ¹³¹I-MIBG by medullary carcinoma of thyroid in familial cases. Eur J Nucl Med 1986; 12(2): 77-9.
    

30. Hilditch TE, Connell JM, Elliot AT, et al. Poor results with technetium-99m (V)DMS and iodine-131 MIBG in the imaging of medullary thyroid carcinoma. J Nucl Med 1986; 27(7): 1150-3.
    

31. van der Steen J, Maessen HJ, Hoefnagel CA, et al. Radiation protection during treatment of children with 131 I-meta-iodobenzylguanidine. Health Phys 1986; 50(4): 515-22.
    

32. Mangner TJ, Tobes MC, Wieland DW, et al. Metabolism of iodine-131 metaiodobenzylguanidine in patients with metastatic pheochromocytoma. J Nucl Med 1986; 27(1): 37-44.
    

33. Shapiro B, Sisson JC, Eyre P, et al. 131 I-MIBG—a new agent in diagnosis and treatment of pheochromocytoma. Cardiology 1985; 72(Suppl 1): 137-42.
    

34. Plewe G, Beyer J, Krause U, et al. Comparison of 131 I-metaiodobenzylguanidine scintigraphy with urinary and plasma catecholamine determinations in the diagnosis of pheochromocytoma. Klin Wochenschr 1985; 63(14): 627-30.
    

35. McEwan AJ, Shapiro B, Sisson JC, et al. Radio-iodobenzylguanidine for the scintigraphic location and therapy of adrenergic tumors. Semin Nucl Med 1985; 15(2): 132-53.
    

36. Nakajo M, Shapiro B, Sisson JC, et al. Salivary gland accumulation of meta-[ ¹³¹I]iodobenzylguanidine. J Nucl Med 1984; 25(1): 2-6.
    

37. Fischer M, Galanski M, Winterberg B, et al. Localization procedures in pheochromocytoma and neuroblastoma. Cardiology 1985; 72(Suppl 1): 143-6.
    

38. USP Radiopharmaceuticals Advisory Panel comments during meeting of 08/04/92.
    

39. Romney BM, et al. Excretion of radioiodine in breast milk (editoral). J Nucl Med. 1989; 30: 124-6.
    

40. Blue PW, Dydek GJ. Excretion of radioiodine in breast milk (letter). J Nucl Med, 1989; 30: 127-8.
    

41. Mountford PJ, Coakley AJ. A review of the secretion of radioactivity in human breast milk: data, quantitative analysis and recommendations. Nucl Med Commun 1989; 10: 15-27.
    

42. Reviewers' comments as per 8/11/92 monograph revision.
    

43. Solanki KK, Bomanji J, Moyes J, et al. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun 1992; 13: 513-21.
    

44. Swanson DP, Chilton HM, Thrall JH, eds. Pharmaceuticals in medical imaging. New York: Macmillan Publishing Company, 1990: 382-6.
    

45. Reviewers' comments as per 2/16/93 monograph revision.
    

46. Iobenguane sulfate I 131 package insert (I-131 MIBG, CIS-US—U.S.), Rev 3/94.
    

47. Reviewers' response to 6/20/94 Ballot.
    

48. The United States pharmacopeia. The national formulary. USP 23rd revision (January 1, 1995). NF 18th ed (January 1, 1995). Rockville, MD: The United States Pharmacopeial Convention, Inc., 1995 (Second supplement, 1995): 2645.
    

49. Reviewer's comment per 10/18/94 revision of technetium Tc 99m teboroxime.
    

Link to this page

Printable Version

Email Page