INDIUM IN 111 CHLORIDE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for INDIUM IN 111 CHLORIDE (INDIUM IN 111 CHLORIDE).
Indium In 111 chloride is a radiopharmaceutical that emits gamma radiation. It binds to transferrin in the blood and is taken up by certain cells, allowing imaging of the reticuloendothelial system or labeled cells.
| Metabolism | Indium In 111 is not metabolized; it decays by electron capture with a physical half-life of 2.8 days. The radiochemical is cleared from the blood and accumulates in the liver, spleen, and bone marrow. |
| Excretion | Renal (90% over 48 hours), fecal (<1% as unchanged). The remainder is retained in organs (liver, spleen, bone marrow) with slow release. |
| Half-life | Physical half-life: 2.804 days (67.3 hours). Biological half-life: 50-100 days for retained fraction. Effective half-life (combined): ~2.7 days for early phase, prolonged for bone marrow. |
| Protein binding | 90-95% bound, primarily to transferrin and other plasma proteins. |
| Volume of Distribution | Vd: 10-20 L (0.15-0.3 L/kg). Indicates distribution into extracellular fluid and binding to transferrin. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Not applicable (diagnostic radiopharmaceutical); imaging begins 1-2 hours post-injection. |
| Duration of Action | Diagnostic utility: 24-72 hours post-injection. Radiological decay: 2.8 days physical half-life. |
Intravenous administration of 1.0 mCi (37 MBq) for routine imaging; dose may range from 0.5 to 2.0 mCi (18.5 to 74 MBq) depending on imaging protocol.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment guidelines are established for renal impairment; use with caution in severe renal dysfunction as clearance may be reduced. |
| Liver impairment | No specific dose adjustment guidelines are established for hepatic impairment based on Child-Pugh score. |
| Pediatric use | Weight-based dose: 0.05 mCi/kg (0.00185 MBq/kg) with a minimum of 0.2 mCi (7.4 MBq) and maximum of 2.0 mCi (74 MBq). |
| Geriatric use | No specific dose adjustment required; consider age-related decline in renal function and potential reduced clearance. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for INDIUM IN 111 CHLORIDE (INDIUM IN 111 CHLORIDE).
| Breastfeeding | Indium In 111 is a radioactive isotope. If administered to a breastfeeding mother, it will be excreted in breast milk. To reduce radiation exposure to the infant, breastfeeding should be interrupted or discontinued. The amount of radioactive material excreted is minimal, but specific M/P ratio is not available. The American College of Radiology recommends a temporary cessation of breastfeeding for a period based on the half-life of the isotope (2.8 days for In-111), typically 1-2 days; however, many guidelines suggest discontinuing breastfeeding for at least 2 days after administration. |
| Teratogenic Risk | Indium In 111 decays by electron capture emitting gamma photons and Auger electrons. The radiation dose to the fetus depends on the stage of pregnancy and the amount of radioactivity administered. All radionuclides have potential to cause fetal harm, including growth retardation, congenital malformations, and increased cancer risk. The risk is highest during the first trimester, especially during organogenesis. Use during pregnancy is contraindicated unless the benefit clearly outweighs the risk. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hypersensitivity to indium or any component of the product","Significant bone marrow suppression (relative contraindication)"]
| Precautions | ["Risk of radiation exposure; use only under strict radiation safety protocols","Caution in pregnant or nursing women due to potential fetal harm","Ensure proper labeling of biological products (e.g., leukocytes) to avoid infection or adverse reactions"] |
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| Fetal Monitoring | Monitor for signs of radiation exposure to the fetus. No specific maternal-fetal monitoring is required beyond standard radiation safety precautions. In cases of inadvertent administration during pregnancy, consult a medical physicist for fetal dose estimation and consider fetal monitoring for potential effects. |
| Fertility Effects | Indium In 111 has not been specifically studied for fertility effects. However, radiation exposure has been associated with reproductive toxicity, including temporary or permanent sterility at high doses. Typical diagnostic doses are unlikely to affect fertility, but precaution should be exercised. |