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VARIOUS › THERAPEUTIC RADIOPHARMACEUTICALS › PAIN PALLIATION (BONE SEEKING AGENTS) › Various pain palliation radiopharmaceuticals
rhenium (186Re) etidronic acid
V10BX03
Forms & Strengths
- Radiopharmaceutical solution for intravenous injection
- Activity usually expressed in MBq or mCi at calibration time, bound to etidronate sodium
Adult Dosing
- Bone pain palliation in skeletal metastases: typically 1290 to 2500 MBq (35 to 67 mCi) administered via slow intravenous injection
- Dosing may be repeated based on hematologic recovery and clinical response, usually after 8 to 12 weeks
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Palliating bone pain in patients with osteoblastic bone metastases
- Adjunct in patients refractory to conventional analgesics and external beam radiation
Mechanism of Action
- Emits beta radiation (and gamma rays for imaging) targeting areas of active bone turnover
- Etidronate localizes to hydroxyapatite crystals in areas of active osteoblastic bone formation
- Delivers localized ionizing radiation to destroy sensory nerve endings and tumor cells in metastatic bone lesions
Contraindications
- Known hypersensitivity to rhenium-186 or bisphosphonates
- Pregnancy and lactation
- Severe renal impairment if systemic clearance is significantly compromised
- Spinal cord compression without prior definitive surgical or radiation decompression
Adverse Reactions
- Myelosuppression (transient leukopenia, thrombocytopenia)
- Bone pain flare (transient increase in bone pain shortly after administration)
- Nausea and vomiting
- Injection site reactions
- Fatigue
Drug Interactions
- Other bone-seeking agents or bisphosphonates may compete for binding sites and alter biodistribution
- Myelosuppressive chemotherapy or external beam radiation may potentiate bone marrow suppression
- Nephrotoxic drugs may impair the renal clearance of the radiopharmaceutical
Curated Content: Needs Vetting Before Put to Clinical Use