Adult Dosing
Myocardial perfusion
- Planar scintigraphy: 37-74 MBq (1-2 mCi) IV
- SPECT myocardial imaging: 74-111 MBq (2-3 mCi) IV
Parathyroid hyperactivity localization
- Planar or SPECT: 75-130 MBq (2-3.5 mCi) IV
Note:
- The efficacy of a 1.0 mCi dose SPECT imaging has not been well established
- Individualize the dose based on factors such as body size and the equipment and technique to be employed
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Therapy may be associated with anaphylactoid reactions such as hypotension, pruritus, flushing, and diffuse rash
- Stress testing should be performed only under the guidance of a qualified physician and in a laboratory well equipped with appropriate resuscitation and support equipment. Continuously monitor patients suspected or known to have myocardial infarction or ischemia and provide treatment in accordance with safe, accepted procedures
- Serious adverse events such as MI, arrhythmia, hypotension or hypertension, ECG abnormalities, chest pain, bronchoconstriction, and cerebrovascular events may be associated with induction of cardiovascular stress. When required, perform pharmacologic stress in accordance with the pharmacologic stress agent’s prescribing information
- Therapy may contribute to cumulative radiation exposure. Consider the radiation risks for a fetus when considering administration of this injection to women of child-bearing potential
- Use the lowest dose essential for imaging and ensure safe handling for protecting the patient and health care provider
- Risk of extravasation exists; strictly inject this drug intravenously to avoid local tissue accumulation and irradiation
- The vial stopper contains dry natural rubber latex that may cause allergic reactions in providers or patients who are sensitive to latex
- Undertake appropriate safety measures to minimize external radiation exposure to patients and clinical personnel
- Only physicians qualified by training and experience in the safe use and handling of radionuclides are eligible for using radiopharmaceuticals
Cautions: Use cautiously in
- Marked alterations in blood glucose, insulin, or pH
Supplemental Patient Information
- Advise patients to inform their physician if they are pregnant or breast-feeding
Pregnancy Category:C
Breastfeeding: Delay elective diagnostic nuclear medicine procedures until the patient is no longer breastfeeding. Interrupt breastfeeding for 2 wks after administration of Tl 201 in a dose of 100 MBq (3 mCi) to a nursing mother. During the period of interruption, the breasts should be emptied regularly and completely. The milk that is pumped by the mother during the time of breastfeeding interruption can either be discarded or stored frozen and given to the infant after 10 physical half-lives, or about 30 days, have elapsed. If the mother has expressed and saved milk prior to the examination, she can feed it to the infant during the period of nursing interruption. Mothers need not refrain from close contact with their infants after doses of 170 MBq or less. Mothers concerned about the level of radioactivity in their milk could have it tested at a nuclear medicine facility at their hospital and may safely resume breastfeeding when the radioactivity is at background levels. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14 September 2011). Because this agent is excreted in human milk, manufacturer advises patients continuing to breastfeed to express and discard milk for a minimum of 2 wks after administration of this drug. Such patients should minimize close contact with infants if the administered dose results in an effective dose >1 mSv (0.1 rem) to the infant.
