DRAXIMAGE DTPA
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DRAXIMAGE DTPA (DRAXIMAGE DTPA).
DRAXIMAGE DTPA (technetium Tc-99m pentetate) is a radiopharmaceutical that, after intravenous injection, distributes in the extracellular space and is cleared by glomerular filtration. It allows imaging of renal function and structure by emitting gamma radiation detectable by a gamma camera.
| Metabolism | DRAXIMAGE DTPA is not metabolized; it is excreted unchanged by the kidneys via glomerular filtration. No hepatic metabolism. |
| Excretion | Renal: 95% within 24 hours via glomerular filtration; biliary/fecal: <5%. |
| Half-life | Terminal elimination half-life is approximately 1.6 hours (range 1.2-2.0 hours) in patients with normal renal function; prolonged in renal impairment (up to 50 hours in severe cases). |
| Protein binding | Negligible (<5%); primarily unbound in plasma. |
| Volume of Distribution | Vd approximately 0.09 L/kg (range 0.07-0.11 L/kg), indicating primarily extracellular fluid distribution. |
| Bioavailability | Intravenous: 100%; no other routes with clinical relevance. |
| Onset of Action | Intravenous: Immediate (<1 minute) for scintigraphic imaging; Inhalation: Not applicable for DTPA; oral: Not applicable. |
| Duration of Action | Intravenous: Imaging window up to 30-60 minutes post-injection; clinical duration correlates with blood pool clearance. |
Diagnostic imaging: 3-5 mCi (111-185 MBq) IV for renal studies; 10-20 mCi (370-740 MBq) IV for lung perfusion imaging.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73 m²) due to risk of excessive radiation exposure; consider alternative imaging. |
| Liver impairment | No adjustment required; DTPA is not hepatically metabolized. |
| Pediatric use | 0.05-0.1 mCi/kg (1.85-3.7 MBq/kg) IV, minimum dose 0.5 mCi (18.5 MBq). |
| Geriatric use | Use standard adult dose; assess renal function and adjust if eGFR <30 mL/min/1.73 m². |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DRAXIMAGE DTPA (DRAXIMAGE DTPA).
| Breastfeeding | Technetium Tc-99m penetratate is excreted in breast milk. M/P ratio not established. Recommend interruption of breastfeeding for 24-48 hours post-administration to minimize infant radiation exposure. Pump and discard milk during this period. |
| Teratogenic Risk | Technetium Tc-99m penetrate (DTPA) is a radiopharmaceutical. Radiation exposure from diagnostic procedures is generally below the threshold for teratogenesis (<50 mGy). First trimester: theoretical risk of stochastic effects; avoid unless benefit outweighs. Second/third trimester: organogenesis complete; low risk of deterministic effects but can affect fetal thyroid if free pertechnetate present. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Known hypersensitivity to technetium Tc-99m or any component of the formulation","Pregnancy (absolute contraindication in high-dose studies)","Breastfeeding (relative; may need to interrupt feeding)"]
| Precautions | ["Risk of allergic reactions including anaphylaxis","Radiation exposure risk; use minimal dose necessary","Caution in patients with impaired renal function (delayed clearance)","Pregnancy and breastfeeding: weigh risks vs benefits","Ensure adequate hydration to minimize radiation exposure to bladder"] |
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| Fetal Monitoring | Assess pregnancy status before administration. Ensure adequate maternal hydration to promote renal clearance and reduce fetal exposure. Monitor for allergic reactions. No specific fetal monitoring required due to low dose. |
| Fertility Effects | Single diagnostic exposure with technetium Tc-99m penetrate is not associated with measurable fertility impairment in either sex. |