MPI INDIUM DTPA IN 111
Clinical safety rating: caution
Comprehensive clinical and safety monograph for MPI INDIUM DTPA IN 111 (MPI INDIUM DTPA IN 111).
Indium In-111 DTPA is a radiopharmaceutical that emits gamma radiation, used for imaging. DTPA chelates indium-111 and, after administration, distributes in the extracellular fluid and is cleared by glomerular filtration, allowing cisternography and renal imaging.
| Metabolism | Not metabolized; excreted unchanged by glomerular filtration. |
| Excretion | Renal: 90% within 24 hours via glomerular filtration; minimal biliary/fecal (<5%). |
| Half-life | Terminal half-life: 2.5-4.0 hours (plasma); prolonged in renal impairment. |
| Protein binding | <5% bound to plasma proteins (mainly albumin). |
| Volume of Distribution | 0.2-0.4 L/kg (confined to extracellular fluid). |
| Bioavailability | Intrathecal: 100% (direct administration); IV: 100% (intravenous). |
| Onset of Action | Intrathecal: immediate imaging via CSF flow within minutes; IV: distribution within 1 hour. |
| Duration of Action | Effective imaging up to 24 hours post-dose; rapid clearance allows repeat studies within 24 hours. |
Adult: 18.5 MBq (0.5 mCi) administered intravenously as a single dose for renal imaging.
| Dosage form | INJECTABLE |
| Renal impairment | No established dose adjustment required; imaging may be delayed in severe renal impairment (GFR <30 mL/min) due to reduced clearance. |
| Liver impairment | No established dose adjustment; radiopharmaceutical not significantly hepatically metabolized. |
| Pediatric use | Weight-based: 3.7 MBq (0.1 mCi) per kg, minimum 18.5 MBq (0.5 mCi), maximum 37 MBq (1 mCi), administered intravenously. |
| Geriatric use | No specific dose adjustment; consider age-related renal function decline and monitor image acquisition timing accordingly. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for MPI INDIUM DTPA IN 111 (MPI INDIUM DTPA IN 111).
| Breastfeeding | Indium-111 DTPA is excreted into breast milk. M/P ratio not established. Theoretical risk of radiation exposure to nursing infant. The manufacturer recommends discontinuing breastfeeding for at least 48 hours (or longer depending on administered activity) after administration. Alternatively, pump and discard milk during this period. |
| Teratogenic Risk | FDA Pregnancy Category D. Indium-111 decays by electron capture emitting gamma photons. Radiation exposure to fetus depends on gestational age and administered activity. First trimester: highest risk of teratogenicity (malformations, growth restriction) from ionizing radiation. Second and third trimesters: risk of fetal CNS damage and carcinogenesis. Risk-benefit assessment required; alternative diagnostic methods should be considered. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Known hypersensitivity to indium In-111 DTPA or any component of the formulation.","Pregnancy (unless clearly necessary) due to potential fetal radiation exposure."]
| Precautions | ["Risk of radiation exposure; minimize exposure to patient and healthcare workers.","Use only with appropriate shielding and radiation safety measures.","Contraindicated in patients with known hypersensitivity to DTPA or indium.","Pregnancy: Use only if benefit outweighs risk; consider alternative imaging.","Lactation: Interrupt breastfeeding for 24-48 hours after administration."] |
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| Fetal Monitoring | Pregnancy testing prior to administration in women of childbearing potential. Radiation dose to fetus should be quantified; consult medical physics. No specific maternal or fetal monitoring post-administration, but patient should be counseled on radiation risks. |
| Fertility Effects | Ionizing radiation from Indium-111 may cause transient or permanent gonadal damage depending on dose. High doses can impair spermatogenesis or oogenesis. However, diagnostic activities (typically <10 mCi) are unlikely to significantly affect fertility. |