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VARIOUS › THERAPEUTIC RADIOPHARMACEUTICALS › ANTIINFLAMMATORY AGENTS › Yttrium (90Y) compounds
yttrium (90Y) citrate colloid
V10AA01
Forms & Strengths
- Yttrium‑90 citrate colloid injection, 150 MBq/mL (4 mCi/mL)
- Sterile glass vials for single‑use intra‑articular administration
- Radiochemical purity ≥95 %
Adult Dosing
- Radiosynoviorthesis: 5–15 MBq (0.135–0.405 mCi) per affected joint; max total activity 185 MBq (5 mCi) per session
- Hepatic arterial infusion (historical use): dose calculated to deliver 0.5–1.0 Gy to target liver, typically 3.7–5.5 GBq (100–150 mCi) per treatment
Pediatric Dosing
- Radiosynoviorthesis: 5–10 MBq per joint (weight‑adjusted, not to exceed 0.2 GBq total)
- Hepatic infusion (rare): 0.2 GBq/m² body surface area, not exceeding 3 GBq total
Indications
- Radiosynoviorthesis for refractory rheumatoid arthritis, hemophilic arthropathy, and other inflammatory joint diseases
- Unresectable hepatocellular carcinoma or hepatic metastases when other locoregional therapies are unsuitable (historical indication)
Mechanism of Action
- Beta‑emitting Y‑90 (Emax 2.28 MeV) delivers high‑energy, short‑range radiation to synovial tissue or tumor microvasculature
- Radiation induces localized cell death, fibrosis, and vascular occlusion without systemic drug exposure
Contraindications
- Pregnancy or lactation
- Active infection or septic arthritis in the target joint
- Severe hepatic dysfunction (Child‑Pugh C) or portal vein thrombosis for liver use
- Absolute contraindication to intra‑arterial embolization
- Known hypersensitivity to citrate or radiocolloid components
Adverse Reactions
- Transient joint pain, swelling, and effusion post‑injection
- Radiation‑induced arthropathy or joint stiffness
- Skin ulceration or necrosis at injection site
- Transient fever, nausea, or mild hepatic enzyme elevation
- Rare leukopenia or radiation‑induced liver disease
Drug Interactions
- Concurrent intra‑articular corticosteroids may diminish therapeutic effect
- Anticoagulants/antiplatelet agents increase risk of joint hemorrhage
- Systemic chemotherapy can potentiate bone‑marrow suppression
- Vasodilators or agents altering hepatic arterial flow may affect distribution during liver infusion
- No clinically significant cytochrome‑P450 interactions
Curated Content: Needs Vetting Before Put to Clinical Use