TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT (TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT).
Technetium Tc 99m albumin aggregated is a radiopharmaceutical that localizes in the pulmonary capillary bed by capillary blockade, allowing for lung perfusion imaging. The aggregated albumin particles are trapped in the pulmonary capillaries, and the Tc 99m emits gamma radiation detectable by gamma cameras.
| Metabolism | Not metabolized; the albumin particles are broken down by the reticuloendothelial system and cleared by the liver. |
| Excretion | Renal: 30-40% within 24 hours (free pertechnetate); fecal: <1% (minor); remainder accumulated in reticuloendothelial system with slow release. |
| Half-life | Physical half-life of Tc-99m is 6.02 hours; biological half-life of aggregated albumin in lungs is 2-4 hours due to enzymatic degradation and clearance. |
| Protein binding | ~30% bound to plasma proteins (primarily albumin) in circulation; binding is reversible and minimal due to rapid lung uptake. |
| Volume of Distribution | Initial distribution approximates plasma volume (~0.05 L/kg); following i.v. injection, the agent rapidly localizes to pulmonary capillary bed with effective Vd of 0.1-0.2 L/kg. |
| Bioavailability | Only administered intravenously; IV bioavailability is 100%. |
| Onset of Action | IV: Immediate pulmonary capillary blockade with scintigraphic visualization within 1-2 minutes post-injection. |
| Duration of Action | Sufficient for lung perfusion imaging: 2-4 hours; complete degradation and clearance of aggregated albumin occurs within 24 hours. |
1-4 mCi (37-148 MBq) intravenous injection for lung perfusion imaging. Single dose per imaging session.
| Dosage form | INJECTABLE |
| Renal impairment | No adjustment required; drug is not significantly renally cleared. |
| Liver impairment | No adjustment required; drug is not hepatically metabolized. |
| Pediatric use | 0.034 mCi/kg (1.26 MBq/kg) with minimum 0.3 mCi (11.1 MBq) and maximum 2 mCi (74 MBq) intravenous. |
| Geriatric use | No specific dose adjustment; use lowest effective dose due to potential renal function decline, though drug not renally cleared. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT (TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT).
| Breastfeeding | Breastfeeding should be interrupted after administration. The amount excreted in milk is low; M/P ratio not established. Specific recommendations: pump and discard milk for 12-24 hours post-injection to minimize infant radiation exposure. |
| Teratogenic Risk | Technetium Tc 99m albumin aggregated (MAA) is a radiopharmaceutical. In pregnancy, fetal exposure to radiation is a concern. First trimester: highest risk for teratogenic effects; use only if benefit outweighs risk. Second/third trimesters: lower but non-negligible risk of childhood cancer; minimize exposure. Fetal absorbed dose is approximately 0.001-0.002 mGy/MBq. |
■ FDA Black Box Warning
WARNING: RISK OF HYPERSENSITIVITY AND ANAPHYLAXIS. Severe allergic reactions, including anaphylaxis, have been reported. Resuscitative equipment and trained personnel should be immediately available.
| Serious Effects |
["Known hypersensitivity to human albumin or any component of the kit"]
| Precautions | ["Risk of anaphylaxis and hypersensitivity reactions","Radiation exposure risk to patients and healthcare providers","Use with caution in patients with severe pulmonary hypertension or right-to-left cardiac shunts","Not for intrathecal use"] |
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| Fetal Monitoring | Monitor for hypersensitivity reactions. In pregnancy, assess fetal well-being if radiation dose exceeds 0.05 Gy. No specific fetal monitoring required for diagnostic doses. |
| Fertility Effects | No known direct effects on fertility from diagnostic doses of Tc-99m MAA. Radiation dose to gonads is low (e.g., ovaries ~0.001 mGy/MBq). No evidence of impaired fertility in humans. |