Adult Dosing
PET imaging
- Recommended dose: 40 mCi (1480 MBq) IV single dose in adult patient (70 kg) with a range of 30-60 mCi (1110-2220 MBq)
- Max dose: 60 mCi (2220 MBq) as a single dose
- Administer the dose at a rate of 50 mL/minute through a catheter inserted into a large peripheral vein
- Max infusion volume: 100 mL
Notes:- Use the lowest dose that will provide adequate cardiac visualization
- Individualize the single dose based on factors such as body size, imaging equipment, and technique
- Administer two separate single doses to complete rest and stress myocardial perfusion imaging as follows:
Rest myocardial perfusion imaging
- Administer a single ("rest") rubidium Rb-82 chloride dose
- Start imaging 60-90 seconds after completion of the infusion and capture images for 5 minutes
- In patients with severe left ventricular dysfunction where a longer circulation time is anticipated, start imaging 120 seconds after the rest dose
Stress myocardial perfusion imaging
- Wait for 10 minutes following completion of the resting dose infusion before starting the study to allow for adequate Rb-82 decay
- Administer the stress agent as per the prescribing information
- After 3 minutes, infuse a single ("stress") dose IV
- Start imaging 60-90 seconds after completion of stress dose infusion and capture images for 5 minutes; begin imaging 120 sec after the stress dose if a longer circulation time is anticipated
Note:
- Refer to package insert for information on radiation dosimetry
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Unintended radiation exposure may occur if the levels of Sr-82 or Sr-85 in the rubidium Rb 82 chloride injection exceed specified limits [Black Box Warning]
- Unintended exposure to strontium radiation may contribute to a patient's overall cumulative radiation dose
- Strictly adhere to a daily eluate testing protocol to prevent the risk of unintended radiation exposure
- Discontinue using the rubidium generator when expiration limits are reached [Black Box Warning]
- Pharmacologic induction of cardiovascular stress may lead to serious adverse events such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction, and cerebrovascular events
- Perform pharmacologic stress testing as per the pharmacologic stress agent's prescribing information only in the presence of trained staff and cardiac resuscitation equipment
- Transitory increase in circulatory volume load may occur in patients with CHF or the elderly. Observe such patients during infusion and for several hrs following injection to detect delayed hemodynamic disturbances
- Long-term cumulative radiation exposure may lead to an increased risk of cancer; use the lowest dose necessary for imaging and ensure safe handling
- Therapy should be performed by physicians who are well trained and experienced in the safe use and handling of radionuclides and whose experience and training have been approved by the appropriate government agency authorized to license the use of radionuclides
Cautions: Use cautiously in
- Congestive heart failure (CHF)
- Nursing women
Supplemental Patient Information
- Encourage patients to void soon after completion of each image acquisition session and as often as possible for at least 1 hour after completion of the PET scan
- Instruct nursing mothers to substitute stored breast milk or infant formula for breast milk for 1 hr after administration of rubidium Rb-82 injection
Pregnancy Category:C
Breastfeeding: It is unknown if rubidium Rb-82 is excreted in human milk. Due to its short half-life, it is unlikely that the drug would be excreted in breastmilk. Manufacturer advises caution. Avoid breastfeeding for 1 hr after the last infusion.
