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Ioflupane I 123

Medically reviewed by Drugs.com. Last updated on Jul 12, 2024.

Pronunciation

(eye oh FLOO pane eye one TWEN tee three)

Index Terms

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous:

DaTscan: 185 MBq/2.5 mL (2.5 mL) [pyrogen free; contains alcohol, usp]

Detailed Ioflupane I 123 dosage information

glucagon, mannitol, Lexiscan, arginine, barium sulfate, Ceretec, iodixanol, Ultravist, iopromide

Brand Names: U.S.

Pharmacologic Category

Pharmacology

Binds to dopamine transporter (DaT) in brain allowing for visualization of regions of interest in the brain to aid in the diagnosis of Parkinsonian syndromes.

Distribution

~30% of radioactivity from the whole brain attributed to striatal uptake

Excretion

At 48 hours postinjection: Urine (~60% ); fecal (~14%)

Onset of Action

Uptake in the brain reached ~7% at 10 minutes after administration

Duration of Action

Duration of radioactivity: Uptake in the brain reached ~3% after 5 hours. Striata to background ratios were constant between 3 to 6 hours after administration.

Half-Life Elimination

Iodine 123: 13.2 hours

Use: Labeled Indications

Brain imaging: Striatal dopamine transporter (DaT) visualization using single photon emission computed tomography (SPECT) brain imaging to assist in the evaluation of adult patients with suspected Parkinsonian syndromes (PS).

Contraindications

Known hypersensitivity to ioflupane I123 or any components of the formulation, or to iodine.

Dosing: Adult

Note: Thyroid protective agents (potassium iodide [SSKI] or Lugol solution) equivalent to 100 mg iodide or 400 mg potassium perchlorate, should be given at least 1 hour prior to ioflupane I123 administration.

Brain imaging: IV: 3 to 5 mCi (111 to 185 MBq); perform SPECT imaging 3 to 6 hours after ioflupane I 123 administration (refer to manufacturer’s prescribing information for additional imaging information).

Dosing: Geriatric

Refer to adult dosing.

Administration

IV: Administer by slow IV injection over at least 15 to 20 seconds via an arm vein. Begin SPECT imaging 3 to 6 hours following IV administration; refer to manufacturer’s prescribing information for additional imaging information. Ensure adequate hydration before and after administration; void frequently for the first 48 hours post administration to minimize bladder exposure.

Radiopharmaceutical; use appropriate precautions for handling and disposal.

Storage

Store at 20°C to 25°C (68°F to 77°F). Store within the original lead container or equivalent radiation shielding.

Drug Interactions

Amoxapine: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Amphetamines: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Benztropine: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

BuPROPion: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

BusPIRone: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Cocaine (Topical): May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Dexmethylphenidate: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

FentaNYL: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Methylphenidate: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Norepinephrine: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Phenylephrine (Systemic): May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Selective Serotonin Reuptake Inhibitors: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Selegiline: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Serotonin/Norepinephrine Reuptake Inhibitors: May diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Ioflupane I 123 drug interactions (more detail)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

≤1%, postmarketing, and/or case reports: Dizziness, headache, nausea, pruritus, skin rash, vertigo, xerostomia

Ioflupane I 123 side effects (more detail)

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: Hypersensitivity reactions have been reported. Use extreme caution in patients with iodine or iodine contrast agent hypersensitivity. Appropriate equipment and emergency medications should be available during use. Hypersensitivity reactions primarily involved skin erythema and/or pruritus; reactions usually resolved spontaneously or following administration of corticosteroids and antihistamines. Monitor for signs/symptoms of hypersensitivity reactions.

Disease-related concerns:

• Renal impairment: Use with caution in patients with severe renal impairment; ioflupane I 123 is eliminated renally. Therefore, patients with severe renal impairment may have increased radiation exposure and altered images. Effect of renal impairment on imaging with ioflupane I 123 has not been established.

Special handling:

• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and shielding to minimize 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.

Other warnings/precautions:

• Appropriate use: To limit thyroid gland accumulation of iodine 123 during exposure to ioflupane I 123, administer thyroid-blocking medications (eg, potassium iodide oral solutions, potassium perchlorate) at least 1 hour prior to administration; increased long-term risk for thyroid neoplasia can occur from failure to block thyroid uptake of iodine 123. Note: Avoid the use of potassium iodide oral solution or Lugol solution in patients with past hypersensitivity to iodine or iodide products.

• Bladder exposure: Patients should be adequately hydrated prior to and following administration; instruct patients to void frequently for 48 hours following administration to decrease radiation exposure to bladder.

Monitoring Parameters

Monitor for signs/symptoms of hypersensitivity reactions. Evaluate pregnancy status prior to use in females of reproductive potential.

Reproductive Considerations

Evaluate pregnancy status prior to use in females of reproductive potential.

Pregnancy Considerations

Radioactive iodine crosses the placenta and may impair fetal thyroid function.

All radiopharmaceuticals have the potential to cause fetal harm. If use is needed during pregnancy, an appropriate thyroid-blocking agent is recommended to protect the mother and fetus from accumulation of I 123. Brain imaging during pregnancy for suspected Parkinsonian syndromes is not recommended in pregnant women (SNM [Djang 2012]).

Patient Education

What is this drug used for?

• It is used before a brain scan.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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