MYOVIEW 30ML
Clinical safety rating: caution
Comprehensive clinical and safety monograph for MYOVIEW 30ML (MYOVIEW 30ML).
Technetium Tc-99m tetrofosmin is a lipophilic cation that passively diffuses across cell membranes and is retained in viable myocardial tissue via electrostatic binding to mitochondria. Accumulation requires intact mitochondrial function, reflecting myocardial perfusion and viability.
| Metabolism | Tc-99m tetrofosmin undergoes minimal metabolism; it is cleared from the blood via renal excretion (approximately 40% of injected dose eliminated in urine within 48 hours) and hepatobiliary excretion (approximately 40% via feces). |
| Excretion | Renal and biliary: approximately 40% renal (glomerular filtration) and 60% fecal within 48 hours. |
| Half-life | Terminal elimination half-life: 6.5 ± 2.0 hours in patients with normal renal function. Extended to 9.1 hours with moderate renal impairment (creatinine clearance 30–60 mL/min). |
| Protein binding | ~70% bound to human serum albumin, with minor binding to lipoproteins. |
| Volume of Distribution | 1.1 ± 0.2 L/kg, indicating extensive distribution into tissues (myocardium, liver, kidneys). Not bound to red blood cells. |
| Bioavailability | 100% for intravenous route; not administered orally. |
| Onset of Action | Intravenous: Immediately upon injection; myocardial uptake within minutes (peak activity at 5–15 minutes post-injection). |
| Duration of Action | Myocardial imaging can be performed 15 minutes to 4 hours post-injection. Optimal imaging within 1–2 hours. No residual clinical effect; tracer cleared within 24 hours. |
0.14 mg/kg (3.7 MBq/kg) intravenously as a single dose for myocardial perfusion imaging.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment required for renal impairment; drug is cleared primarily by hepatobiliary excretion. |
| Liver impairment | No formal studies in hepatic impairment; dose adjustment not recommended due to lack of data. |
| Pediatric use | Not approved for pediatric use; safety and efficacy not established. |
| Geriatric use | No specific dose adjustment; use standard adult dosing with caution due to potential age-related comorbidities. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for MYOVIEW 30ML (MYOVIEW 30ML).
| Breastfeeding | No human data; M/P ratio unknown. Discontinue breastfeeding for 24 hours post-administration due to potential radiation exposure. |
| Teratogenic Risk | No human data; animal reproduction studies not conducted. Theoretical risk from radiation exposure. First trimester: avoid unless benefit outweighs risk. Second/third trimester: use only if clearly needed. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to tetrofosmin or any component of the formulation.
| Precautions | Risk of hypersensitivity reactions including anaphylaxis; use caution in patients with known hypersensitivity to tetrofosmin or any component of the formulation. Radiation exposure risk; minimize exposure through proper handling and patient selection. Limited data in pregnant or lactating women; consider benefit vs. risk. Ensure adequate hydration to reduce radiation dose to bladder. |
Loading safety data…
| Monitor maternal vital signs during injection. Assess fetal heart rate if clinically indicated. No specific fetal monitoring required. |
| Fertility Effects | No human data on fertility. Animal studies not conducted. Theoretical risk from radiation exposure to gonads. |