Source: FDA, National Drug Code (US) Revision Year: 2020
None.
Sodium Pertechnetate Tc-99m contributes to a patient’s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Use the lowest dose of Sodium Pertechnetate Tc-99m necessary for imaging and ensure safe handling and preparation to protect the patient and health care worker from unintentional radiation exposure. Encourage patients to drink fluids and void as frequently as possible after intravenous or intravesicular administration. Advise patients to blow their nose and wash their eyes with water after ophthalmic administration [see Dosage and Administration (2.1)].
Radiation risks associated with the use of Sodium Pertechnetate Tc-99m are greater in pediatric patients than in adults due to greater absorbed radiation doses and longer life expectancy. Ensure the diagnostic benefit of Sodium Pertechnetate Tc-99m outweighs these greater risks prior to administration in pediatric patients.
Unintended exposure to Mo-99 radiation contributes to a patient’s overall cumulative radiation dose. To minimize the risk of unintended radiation exposure, strict adherence to the eluate testing protocol is required. Use only potassium molybdate Mo-99, processing reagents, saline, and other supplies, including kits, provided by NorthStar Medical Radioisotopes, LLC. Do not administer Sodium Pertechnetate Tc 99m Injection after the 0.15 microCi of Mo-99/mCi of Tc-99m limit has been reached and discard the Sodium Pertechnetate Tc 99m Injection when the 12 hour expiration time is reached; whichever occurs earlier [see Dosage and Administration (2.7)].
Sodium Pertechnetate Tc 99m Injection from the first elution of Potassium Molybdate Mo-99 Source Vessel on the RadioGenix System may contain Rhenium Re-186, and may exceed USP limits for unspecified beta and gamma-emitting radionuclide impurities. Unintended exposure to Re-186 radiation contributes to a patient’s overall cumulative radiation dose. To minimize the risk of unintended radiation exposure from Re-186, discard the first eluate from every new Potassium Molybdate Mo-99 Source Vessel [See Dosage and Administration (2.6)].
Hypersensitivity reactions, including serious signs and symptoms of anaphylaxis, following administration of Sodium Pertechnetate Tc 99m Injection have been reported. Always have cardiopulmonary resuscitation equipment and personnel available and monitor all patients for hypersensitivity reactions.
Sodium Pertechnetate Tc-99m contributes to a patient’s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Use the lowest dose of Sodium Pertechnetate Tc-99m necessary for imaging and ensure safe handling and preparation to protect the patient and healthcare worker from unintentional radiation exposure. Encourage patients to drink fluids and void as frequently as possible after intravenous or intravesicular administration. Advise patients to blow their nose and wash their eyes with water after ophthalmic administration [see Dosage and Administration (2.1)].
Radiation risks associated with the use of Sodium Pertechnetate Tc-99m are greater in pediatric patients than in adults due to greater absorbed radiation doses and longer life expectancy. Ensure the diagnostic benefit of Sodium Pertechnetate Tc-99m outweighs these greater risks prior to administration in pediatric patients.
Unintended exposure to Mo-99 radiation contributes to a patient’s overall cumulative radiation dose. To minimize the risk of unintended radiation exposure, strict adherence to the eluate testing protocol is required. Use only potassium molybdate Mo 99, processing reagent, saline, and other supplies, including kit and packs, provided by NorthStar Medical Radioisotopes, LLC. Do not administer Sodium Pertechnetate Tc 99m Injection after the 0.15 microCi of Mo 99/mCi of Tc 99m limit has been reached and discard the Sodium Pertechnetate Tc 99m Injection when the 12 hour expiration time is reached, whichever occurs earlier [see Dosage and Administration (2.7)].
Sodium Pertechnetate Tc 99m Injection from the first elution of Potassium Molybdate Mo-99 Source Vessel on the RadioGenix System may contain Rhenium Re-186, and may exceed USP limits for unspecified beta and gamma-emitting radionuclide impurities. Unintended exposure to Re-186 radiation contributes to a patient’s overall cumulative radiation dose. To minimize the risk of unintended radiation exposure from Re-186, discard the first eluate from every new Potassium Molybdate Mo-99 Source Vessel [See Dosage and Administration (2.6)].
Hypersensitivity reactions, including serious signs and symptoms of anaphylaxis, following administration of Sodium Pertechnetate Tc 99m Injection have been reported. Always have cardiopulmonary resuscitation equipment and personnel available and monitor all patients for hypersensitivity reactions.
The following adverse reactions are described elsewhere in the labeling:
The following adverse reactions associated with the use of Sodium Pertechnetate Tc 99m Injection have been identified in postmarketing experience. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Allergic reactions (skin rash, hives, or itching) including anaphylaxis has been reported following the administration of Sodium Pertechnetate Tc-99m.
The following adverse reactions are described elsewhere in the labeling:
The following adverse reactions associated with the use of Sodium Pertechnetate Tc 99m Injection have been identified in postmarketing experience. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Allergic reactions (skin rash, hives, or itching) including anaphylaxis have been reported following the administration of Sodium Pertechnetate Tc-99m.
There are no available data with Sodium Pertechnetate Tc-99m use in pregnant women to inform any drug-associated risks of developmental outcomes. Animal reproductive studies have not been conducted with Sodium Pertechnetate Tc-99m. All radiopharmaceuticals, including Sodium Pertechnetate Tc-99m, have the potential to cause fetal harm depending on the fetal stage of development and the magnitude of the radiation dose. If considering Sodium Pertechnetate Tc-99m administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from Sodium Pertechnetate Tc-99m and the gestational timing of exposure.
The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.
There are limited data available in the published literature on the presence of technetium Tc-99m in human milk. There are no data available on the effects of Sodium Pertechnetate Tc-99m on the breast fed infant or the effects on milk production. Exposure of Sodium Pertechnetate Tc-99m to a breastfed infant can be minimized by temporary discontinuation of breast feeding (see Clinical Considerations). The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Sodium Pertechnetate Tc-99m, any potential adverse effects on the breastfed child from Sodium Pertechnetate Tc-99m or from the underlying maternal condition.
To decrease radiation exposure to the breastfed infant, advise a lactating woman to pump and discard breastmilk after the administration of Sodium Pertechnetate Tc-99m for 12 to 24 hours, where the duration corresponds to the typical range of administrated activity, 259 MBq to 925 MBq (7 mCi to 25 mCi).
Safety and effectiveness have been established for Sodium Pertechnetate Tc-99m in pediatric patients from birth (term neonates) to 17 years of age of age for thyroid imaging and for urinary bladder imaging via direct isotopic cystography for the detection of vesicoureteral reflux based on clinical experience. Safety and effectiveness have not been established in pediatric patients for salivary gland imaging or nasolacrimal drainage system imaging. Although dose adjustment based on body size or weight is generally recommended, the administered dose should be adequate to obtain acceptable quality diagnostic information [see Dosage and Administration 2.4]. Radiation risks of Sodium Pertechnetate Tc 99m Injection are greater in pediatric patients than adults [see Warnings and Precautions (5.1)].
Studies on the relationship of age to the effects of Sodium Pertechnetate Tc-99m Injection have not been performed in the geriatric population. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
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