Indium oxyquinoline: Difference between revisions

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{{DrugProjectFormSinglePage
|authorTag={{AV}}
|genericName=INDIUM IN 111 OXYQUINOLINE
|aOrAn=a
|drugClass=Diagnostic Agent
|indicationType=diagnosis
|indication=radiolabeling [[autologous]] [[leukocytes]]. Indium In 111 oxyquinoline labeled leukocytes may be used as an adjunct in the detection of [[inflammation|inflammatory processes]] to which [[leukocytes]] migrate, such as those associated with [[abscesses]] or other [[infection]], following reinjection and detection by appropriate imaging procedures.
|adverseReactions=[[hypersensitivity reaction]]




==Indium Oxyquinoline Description==
<!--Black Box Warning-->
|blackBoxWarningTitle=Title
|blackBoxWarningBody=<i><span style="color:#FF0000;">ConditionName: </span></i>


Indium In 111 oxyquinoline (oxine) is a diagnostic radiopharmaceutical intended for radiolabeling autologous leukocytes. It is supplied as a sterile, non-pyrogenic, isotonic aqueous solution with a pH range of 6.5 to 7.5. Each mL of the solution contains 37 MBq, 1 mCi of indium In 111 [no carrier added, >1.85 GBq/µg indium (>50 mCi/µg indium)] at calibration time, 50 µg oxyquinoline, 100 µg polysorbate 80, and 6 mg of HEPES (N-2-hydroxyethylpiperazine-N'-2-ethane sulfonic acid) buffer in 0.75% sodium chloride solution. The drug is intended for single use only and contains no bacteriostatic agent. The radionuclidic impurity limit for indium 114m is not greater than 37 kBq, 1 µCi of indium 114m per 37 MBq, 1 mCi of indium In 111 at the time of calibration. The radionuclidic composition at expiration time is not less than 99.75% of indium In 111 and not more than 0.25% of indium In 114m/114.
* Content


Chemical name: Indium In 111 Oxyquinoline.
<!--Adult Indications and Dosage-->


The precise structure of the indium In 111 oxyquinoline complex is unknown at this time. The empirical formula is (C9H6NO)3 In 111.
<!--FDA-Labeled Indications and Dosage (Adult)-->
|fdaLIADAdult======Radiolabeling autologous leukocytes=====


==Physical Characteristics==
*Indium In 111 oxyquinoline is indicated for radiolabeling [[autologous]] [[leukocytes]].


Indium In 111 decays by electron capture with a physical half-life of 67.2 hours (2.8 days). The energies of the photons that are useful for detection and imaging studies.
*Indium In 111 oxyquinoline labeled [[leukocytes]] may be used as an adjunct in the detection of inflammatory processes to which [[leukocytes]] migrate, such as those associated with abscesses or other [[infection]], following reinjection and detection by appropriate imaging procedures. The degree of accuracy may vary with labeling techniques and with the size, location and nature of the inflammatory process.


==External Radiation==
*Indium In 111 oxyquinoline labeled leukocyte imaging is not the preferred technique for the initial evaluation of patients with a high clinical probability of an [[abscess]] in a known location. [[Ultrasound]] or [[computed tomography]] may provide a better anatomical delineation of the [[infection|infectious process]] and information may be obtained more quickly than with labeled [[leukocytes]]. If localization by these techniques is successful, labeled [[leukocytes]] should not be used as a confirmatory procedure. If localization or diagnosis by these methods fails or is ambiguous, indium In 111 oxyquinoline labeled leukocyte imaging may be appropriate.


The exposure rate constant for 37 MBq, 1 mCi indium In 111 is 8.3 × 10-4 C/kg/h (3.21 R/h) at 1 cm. The first half value thickness of lead (Pb) for indium In 111 is 0.023 cm. A range of values for the relative attenuation of the radiation emitted by this radionuclide that results from the interposition of various thicknesses of Pb is shown in Table 2. For example, the use of 0.834 cm of lead will decrease the external radiation exposure by a factor of about 1,000.
======Dosing Information======


These estimates of attenuation do not take into consideration the presence of longer-lived contaminants with higher energy photons, namely indium In 114m/114.
*The recommended adult (70 kg) dose of indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]] is 7.4 to 18.5 MBq, 200-500 µCi. Indium In 111 oxyquinoline solution is intended for the [[radiolabel|radiolabeling]] of [[autologous]] [[leukocytes]]. The indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]] are administered intravenously.


==Indium Oxyquinoline - Clinical Pharmacology==
*Imaging is recommended at approximately 24 hours post injection. Typically, anterior and posterior views of the chest, abdomen and pelvis should be obtained with other views as required.


Indium forms a saturated (1:3) complex with oxyquinoline. The complex is neutral and lipid-soluble, which enables it to penetrate the cell membrane. Within the cell, indium becomes firmly attached to cytoplasmic components; the liberated oxyquinoline is released by the cell. It is thought likely that the mechanism of labeling cells with indium In 111 oxyquinoline involves an exchange reaction between the oxyquinoline carrier and subcellular components which chelate indium more strongly than oxyquinoline. The low stability constant of the oxyquinoline complex, estimated at approximately 10, supports this theory.
*Aseptic procedures and a shielded syringe should be employed in the withdrawal of indium In 111 oxyquinoline from the vial. Similar procedures should be employed during the labeling procedure and the administration of the labeled [[leukocytes]] to the patient. The user should wear waterproof gloves during the entire procedure. The patient's dose should be measured by a suitable [[radioactivity]] calibration system immediately before administration. At this time, the leukocyte preparation should be checked for gross [[clumping]] and [[red blood cell]] contamination.
<!--Off-Label Use and Dosage (Adult)-->


Following the recommended leukocyte cell labeling procedure, approximately 77% of the added indium In 111 oxyquinoline is incorporated in the resulting cell pellet (which represents approximately 3-4 × 108 WBC).
<!--Guideline-Supported Use (Adult)-->
|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.


Cell clumping can occur and was found in about one fifth of the leukocyte preparations examined. The presence of red blood cells or plasma will lead to reduced leukocyte labeling efficiency. Transferrin in plasma competes for indium In 111 oxyquinoline.
<!--Non–Guideline-Supported Use (Adult)-->
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.


After injection of labeled leukocytes into normal volunteers, about 30% of the dose is taken up by spleen and 30% by liver, reaching a plateau at 2-48 hours after injection. No significant clearance of radioactivity is observed at 72 hours in these two organs. Pulmonary uptake is 4-7.5% at 10 minutes but is lost rapidly; pulmonary radioactivity is usually visible in scans only up to about 4 hours after injection.
<!--Pediatric Indications and Dosage-->


The human biodistribution studies in three normal subjects injected with indium In 111 oxyquinoline labeled leukocytes indicate a biexponential disappearance of indium In 111 from the blood when monitored for up to 72 hours. Between 9.5 to 24.4% of the injected dose remains in whole blood and clears with a biological half-time of 2.8 to 5.5 hours. The remainder (13-18%) clears from blood with a biological half-time of 64 to 116 hours.
<!--FDA-Labeled Indications and Dosage (Pediatric)-->
|fdaLIADPed=There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.


Elimination from the body of injected indium In 111 oxyquinoline is probably mainly through decay to stable cadmium since only a negligible amount (less than 1%) of the dose is excreted in feces and urine in 24 hours.
<!--Off-Label Use and Dosage (Pediatric)-->


Clearance from whole blood and biological distribution can vary considerably with the individual recipient, the condition of the injected cells and labeling techniques used.
<!--Guideline-Supported Use (Pediatric)-->
|offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.


Release of radioactivity from the labeled cells is about 3% at 1 hour and 24% at 24 hours.
<!--Non–Guideline-Supported Use (Pediatric)-->
|offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.


Clearance from liver and spleen, for the purpose of calculating the radiation dose, is assumed to be equal to the physical half-life of indium In 111 (67.2 hours).
<!--Contraindications-->
|contraindications=* None known.


==Indications and Usage for Indium Oxyquinoline==
<!--Warnings-->
|warnings=*The content of the vial of indium In 111 oxyquinoline solution is intended only for use in the preparation of indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]], and is not to be administered directly. [[Autologous]] [[leukocyte]] labeling is not recommended in [[leukopenia|leukopenic patients]] because of the small number of available [[leukocytes]].


Indium In 111 oxyquinoline is indicated for radiolabeling autologous leukocytes.
*Due to radiation exposure, indium In 111 oxyquinoline labeled leukocytes could cause fetal harm when administered to pregnant women. If this radiopharmaceutical is used during [[pregnancy]], the patient should be informed of the potential hazard to the fetus.


Indium In 111 oxyquinoline labeled leukocytes may be used as an adjunct in the detection of inflammatory processes to which leukocytes migrate, such as those associated with abscesses or other infection, following reinjection and detection by appropriate imaging procedures. The degree of accuracy may vary with labeling techniques and with the size, location and nature of the inflammatory process.
*Indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]] should be used only when the benefit to be obtained exceeds the risks involved in children under eighteen years of age owing to the high [[radiation]] burden and the potential for delayed manifestation of long-term adverse effects.


Indium In 111 oxyquinoline labeled leukocyte imaging is not the preferred technique for the initial evaluation of patients with a high clinical probability of an abscess in a known location. Ultrasound or computed tomography may provide a better anatomical delineation of the infectious process and information may be obtained more quickly than with labeled leukocytes. If localization by these techniques is successful, labeled leukocytes should not be used as a confirmatory procedure. If localization or diagnosis by these methods fails or is ambiguous, indium In 111 oxyquinoline labeled leukocyte imaging may be appropriate.
=====Precautions=====


==Contraindications==
*[[Clumping]] of cells may produce focal accumulations of radioactivity in [[lungs]] which do not wash out in 24 hours and thus may lead to false positive results. This phenomenon can be detected by imaging the chest immediately after [[injection]].


None known.
*The normally high uptake of indium In 111 oxyquinoline labeled [[leukocytes]] by [[spleen]] and [[liver]] may mask inflammatory lesions in these organs. Labeled [[leukocytes]] have been observed to accumulate in the [[colon]] and [[accessory spleens]] of patients with or without disease.


==Warnings==
*[[Chemotaxis]] of [[granulocytes]] deteriorates during storage and loss of [[chemotaxis]] may cause false negative scans. The spontaneous release of indium In 111 has been reported to range from about 3% at one hour to 24% at 24 hours. The maximum amount of time recommended between drawing the blood and reinjection should not exceed 5 hours. It is recommended that the labeled cells be used within one hour of preparation, if possible and in no case more than three hours after preparation.


The content of the vial of indium In 111 oxyquinoline solution is intended only for use in the preparation of indium In 111 oxyquinoline labeled autologous leukocytes, and is not to be administered directly. Autologous leukocyte labeling is not recommended in leukopenic patients because of the small number of available leukocytes.
*Plasma and red cell contamination impairs labeling efficiency of leukocytes. Hemolyzed blood in labeled [[leukocytes]] may produce heart pool activity and should be avoided.


Due to radiation exposure, indium In 111 oxyquinoline labeled leukocytes could cause fetal harm when administered to pregnant women. If this radiopharmaceutical is used during pregnancy, the patient should be informed of the potential hazard to the fetus.
*Cell aggregates of various degrees have been reported. Cell labeling techniques and standing of cell preparation may be contributing factors.


Indium In 111 oxyquinoline labeled autologous leukocytes should be used only when the benefit to be obtained exceeds the risks involved in children under eighteen years of age owing to the high radiation burden and the potential for delayed manifestation of long-term adverse effects.
*[[Nuclear medicine]] procedures involving withdrawal and reinjection of blood have the potential for transmission of blood borne pathogens. Procedures should be implemented to avoid administration errors and viral contamination of personnel during blood product labeling. A system of checks similar to the ones used for administering [[blood transfusions]] should be routine.


==Precautions==
======General======


Clumping of cells may produce focal accumulations of radioactivity in lungs which do not wash out in 24 hours and thus may lead to false positive results. This phenomenon can be detected by imaging the chest immediately after injection.
*Strict aseptic techniques should be used to maintain [[sterility]] throughout the procedures for using this product.


The normally high uptake of indium In 111 oxyquinoline labeled leukocytes by spleen and liver may mask inflammatory lesions in these organs. Labeled leukocytes have been observed to accumulate in the colon and accessory spleens of patients with or without disease.
*Do not use after the expiration time and date (5 days after calibration time) stated on the label.


Chemotaxis of granulocytes deteriorates during storage and loss of chemotaxis may cause false negative scans. The spontaneous release of indium In 111 has been reported to range from about 3% at one hour to 24% at 24 hours [ten Berge, R.J.M., Natarajan, A.T., Hardeman, M.R., et al, Labeling with indium In 111 has detrimental effects on human lymphocytes, Journal of Nuclear Medicine, 24, 615-620 (1983)]. The maximum amount of time recommended between drawing the blood and reinjection should not exceed 5 hours. It is recommended that the labeled cells be used within one hour of preparation, if possible and in no case more than three hours after preparation.
*The contents of the vial are radioactive. Adequate shielding of the preparation must be maintained at all times.


Plasma and red cell contamination impairs labeling efficiency of leukocytes. Hemolyzed blood in labeled leukocytes may produce heart pool activity and should be avoided.
*Indium In 111 oxyquinoline, like other [[radioactive drugs]], must be handled with care and appropriate safety measures should be used to minimize [[radiation]] exposure to clinical personnel. Care should also be taken to minimize radiation exposure to the patient consistent with proper patient management.


Cell aggregates of various degrees have been reported. Cell labeling techniques and standing of cell preparation may be contributing factors.
*[[Radiopharmaceuticals]] should be used only by physicians who are qualified by training and experience in the safe use and handling of [[radionuclides]] and whose experience and training have been approved by the appropriate governmental agency authorized to license the use of radio-nuclides.


Nuclear medicine procedures involving withdrawal and reinjection of blood have the potential for transmission of blood borne pathogens. Procedures should be implemented to avoid administration errors and viral contamination of personnel during blood product labeling. A system of checks similar to the ones used for administering blood transfusions should be routine.
<!--Adverse Reactions-->


==General==
<!--Clinical Trials Experience-->
|clinicalTrials=*Sensitivity reactions ([[urticaria]]) have been reported. The presence of fever may mask pyrogenic reactions from indium In 111 oxyquinoline labeled [[leukocytes]]. The possibility of delayed adverse reactions has not been studied.


Strict aseptic techniques should be used to maintain sterility throughout the procedures for using this product.
<!--Postmarketing Experience-->
|postmarketing=There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label.


Do not use after the expiration time and date (5 days after calibration time) stated on the label.
<!--Drug Interactions-->
|drugInteractions=<!--Use in Specific Populations-->
|FDAPregCat=C
|useInPregnancyFDA=* Animal reproduction studies have not been conducted with Indium In 111 Oxyquinoline labeled [[leukocytes]]. It is also not known whether Indium In 111 Oxyquinoline labeled [[leukocytes]] can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.


The contents of the vial are radioactive. Adequate shielding of the preparation must be maintained at all times.
*However, Indium Nitrate, a closely related compound, was [[teratogenic]] and embryopathic in hamsters. Indium In 111 Oxyquinoline labeled [[leukocytes]] should be given to a pregnant woman only if clearly needed.


Indium In 111 oxyquinoline, like other radioactive drugs, must be handled with care and appropriate safety measures should be used to minimize radiation exposure to clinical personnel. Care should also be taken to minimize radiation exposure to the patient consistent with proper patient management.
*Ideally, examinations using radiopharmaceuticals, especially those elective in nature, in women of childbearing capability should be performed during the first few (approximately ten) days following the onset of menses.
|useInPregnancyAUS=There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of {{PAGENAME}} in women who are pregnant.
|useInLaborDelivery=There is no FDA guidance on use of {{PAGENAME}} during labor and delivery.
|useInNursing=*It is reported that indium 111 is secreted in human milk following administration of indium In 111 labeled leukocytes. Therefore, formula feedings should be substituted for breast feedings.
|useInPed=*Safety and effectiveness in pediatric patients below age 18 have not been established
|useInGeri=*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.
|useInGender=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific gender populations.
|useInRace=There is no FDA guidance on the use of {{PAGENAME}} with respect to specific racial populations.
|useInRenalImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with [[renal impairment]].
|useInHepaticImpair=There is no FDA guidance on the use of {{PAGENAME}} in patients with [[hepatic impairment]].
|useInReproPotential=There is no FDA guidance on the use of {{PAGENAME}} in women of reproductive potentials and males.
|useInImmunocomp=There is no FDA guidance one the use of {{PAGENAME}} in patients who are [[immunocompromised]].


Radiopharmaceuticals should be used only by physicians who are qualified by training and experience in the safe use and handling of radionuclides and whose experience and training have been approved by the appropriate governmental agency authorized to license the use of radio-nuclides.
<!--Administration and Monitoring-->
|administration=*[[Intravenous]]
|monitoring=*Image quality of radiolabeled [[leukocytes]] is indicative of efficacy
<!--IV Compatibility-->
|IVCompat=There is limited information regarding <i>IV Compatibility</i> of {{PAGENAME}} in the drug label.


==Carcinogenesis, Mutagenesis, Impairment of Fertility==
<!--Overdosage-->
|overdose=There is limited information regarding <i>Chronic Overdose</i> of {{PAGENAME}} in the drug label.


Although earlier studies suggested that oxyquinoline (oxine) might have carcinogenic potential, recent studies have found no evidence of carcinogenicity in either rats or mice given oxyquinoline in feed at concentrations of 1,500 or 3,000 ppm for 103 weeks.
<!--Pharmacology-->


It has been reported [ten Berge, R.J.M., Natarajan, A.T., Hardeman, M.R., et al, Labeling with indium In 111 has detrimental effects on human lymphocytes, Journal of Nuclear Medicine, 24, 615-620 (1983)] that human lymphocytes labeled with recommended concentrations of indium In 111 oxyquinoline showed chromosome aberrations consisting of gaps, breaks and exchanges that appear to be radiation induced. At 555 kBq/107, 15 µCi/107 lymphocytes 93% of the cells were reported to be abnormal. The oncogenic potential of such lymphocytes has not been studied. It has been reported that the radiation dose to 108 leukocytes is 9 × 104 mGy (0.9 × 104 rads) from 18.5 MBq, 500 µCi [Goodwin, David A., Cell labeling with oxine chelates of radioactive metal ions: Techniques and clinical implications, Journal of Nuclear Medicine, 19, 557-559 (1978)].
<!--Drug box 2-->
|drugBox=[[File:Oxyquinoline00.png|thumb|none|400px|This image is provided by the National Library of Medicine.]]


Studies have not been performed to evaluate whether indium In 111 oxyquinoline affects fertility in male or female laboratory animals or humans.


Pregnancy Category C


Animal reproduction studies have not been conducted with Indium In 111 Oxyquinoline labeled leukocytes. It is also not known whether Indium In 111 Oxyquinoline labeled leukocytes can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
<!--Mechanism of Action-->
|mechAction=*Indium forms a saturated (1:3) complex with oxyquinoline. The complex is neutral and lipid-soluble, which enables it to penetrate the cell membrane. Within the cell, indium becomes firmly attached to cytoplasmic components; the liberated oxyquinoline is released by the cell. It is thought likely that the mechanism of labeling cells with indium In 111 oxyquinoline involves an exchange reaction between the oxyquinoline carrier and subcellular components which [[chelate]] indium more strongly than oxyquinoline. The low stability constant of the oxyquinoline complex, estimated at approximately 10, supports this theory.


However, Indium Nitrate, a closely related compound, was teratogenic and embryopathic in hamsters. Indium In 111 Oxyquinoline labeled leukocytes should be given to a pregnant woman only if clearly needed.
<!--Structure-->
 
|structure=*Indium In 111 oxyquinoline (oxine) is a diagnostic radiopharmaceutical intended for radiolabeling autologous leukocytes. It is supplied as a sterile, non-pyrogenic, isotonic aqueous solution with a pH range of 6.5 to 7.5. Each mL of the solution contains 37 MBq, 1 mCi of indium In 111 [no carrier added, >1.85 GBq/µg indium (>50 mCi/µg indium)] at calibration time, 50 µg oxyquinoline, 100 µg polysorbate 80, and 6 mg of HEPES (N-2-hydroxyethyl-piperazine-N'-2-ethane sulfonic acid) buffer in 0.75% sodium chloride solution. The drug is intended for single use only and contains no [[bacteriostatic agent]]. The radionuclidic impurity limit for indium 114m is not greater than 37 kBq, 1 µCi of indium 114m per 37 MBq, 1 mCi of indium In 111 at the time of calibration. The radionuclidic composition at expiration time is not less than 99.75% of indium In 111 and not more than 0.25% of indium In 114m/114.
Ideally, examinations using radiopharmaceuticals, especially those elective in nature, in women of childbearing capability should be performed during the first few (approximately ten) days following the onset of menses.
Chemical name: Indium In 111 Oxyquinoline.
 
==Nursing Mothers==
 
It is reported that indium 111 is secreted in human milk following administration of indium In 111 labeled leukocytes. Therefore, formula feedings should be substituted for breast feedings.
 
==Pediatric Use==
 
Safety and effectiveness in pediatric patients below age 18 have not been established (See Warnings).
 
==Adverse Reactions==
 
Sensitivity reactions (urticaria) have been reported. The presence of fever may mask pyrogenic reactions from indium In 111 oxyquinoline labeled leukocytes. The possibility of delayed adverse reactions has not been studied.
 
==Indium Oxyquinoline Dosage and Administration==
 
The recommended adult (70 kg) dose of indium In 111 oxyquinoline labeled autologous leukocytes is 7.4 to 18.5 MBq, 200-500 µCi. Indium In 111 oxyquinoline solution is intended for the radiolabeling of autologous leukocytes. The indium In 111 oxyquinoline labeled autologous leukocytes are administered intravenously.
 
Imaging is recommended at approximately 24 hours post injection. Typically, anterior and posterior views of the chest, abdomen and pelvis should be obtained with other views as required.
 
Aseptic procedures and a shielded syringe should be employed in the withdrawal of indium In 111 oxyquinoline from the vial. Similar procedures should be employed during the labeling procedure and the administration of the labeled leukocytes to the patient. The user should wear waterproof gloves during the entire procedure. The patient's dose should be measured by a suitable radioactivity calibration system immediately before administration. At this time, the leukocyte preparation should be checked for gross clumping and red blood cell contamination.
 
The dose of radiation absorbed by the organs will vary with the distribution of the blood cells in the organs, which in turn will depend on the predominance of the cell types labeled and their condition.
 
==LABELING PROCEDURE==
 
Sterile technique must be used throughout. It is important that all equipment used for the preparation of reagents be thoroughly cleaned to assure the absence of trace metal impurities. The user should wear waterproof gloves during the handling and administration procedure.
 
1. The following equipment is recommended:
*One (1) 60 mL or two (2) 30 mL sterile disposable plastic syringes with a 19 or 20 gauge needle (NOTE: Do not use a smaller gauge needle).
*Ring stand and clamp(s).
*Three (3) 50 mL sterile conical plastic centrifuge tubes with screw caps. Label each set with patient ID and "WBC", "LPP" and "Wash" respectively (NOTE: 3 centrifuge tubes per patient).
*Clinical Centrifuge with horizontal, 4 place rotor or equivalent.
*Sodium Chloride 0.9% Injection, USP.
*Three (3) disposable 5 or 10 mL syringes and 19 gauge needles.
*Syringe shield to dispense indium In 111 oxyquinoline.
*A dose calibrator.
*Butterfly catheter infusion set.
*Test tube rack.
*Lab timer.
*10 mL syringe with a 19 gauge or 20 gauge needle.
*19 gauge needle with filter (optional).
 
2. Withdraw from the patient 30-50 mL blood [preferably fifty (50) mL] using aseptic venipuncture technique using the 60 mL syringe fitted with a 19 gauge or 20 gauge needle and containing approximately 1000-1500 units heparin in 1-2 mL. Blood withdrawal should be smooth and slow so as not to produce bubbles or foaming.
 
3. Remove and dispose of the needle and replace with a syringe cap. Gently mix the contents of the syringe and label with the patient's ID, date and time.
 
4. Upon receipt of the full syringe for processing, the contents should again be gently mixed.
 
5. Clamp the syringe barrel to the ring stand in an upright (needle side up) position and tilt the syringe 10-20 degrees from its position perpendicular to the bench.
 
6. Allow the red cells to sediment 30-60 minutes, depending upon when the supernatant [leukocyte rich plasma (LRP)] looks clear of red blood cells.
 
7. Replace the syringe cap with an infusion set.
 
8. Collect the plasma (LRP) in the centrifuge tube marked "WBC" by expressing the LRP through the catheter tubing making sure not to get any red cells into the WBC tube.


9. Immediately centrifuge the capped WBC tube at 400-450 g for 5 minutes.
*The precise structure of the indium In 111 oxyquinoline complex is unknown at this time. The empirical formula is (C9H6NO)3 In 111.  


10. Transfer the supernatant to the leukocyte poor plasma (LPP) tube leaving behind 0.5-1.0 mL supernatant to cover the white cell button (NOTE: the button often contains a small number of red cells and may appear red).
<!--Pharmacodynamics-->
|PD=There is limited information regarding <i>Pharmacodynamics</i> of {{PAGENAME}} in the drug label.


11. Wash the white cell button with 4-6 mL Sodium Chloride (0.9%) Injection, USP. Resuspend the button by gentle swirling.
<!--Pharmacokinetics-->
|PK=*Following the recommended leukocyte cell labeling procedure, approximately 77% of the added indium In 111 oxyquinoline is incorporated in the resulting cell pellet (which represents approximately 3-4 × 108 WBC).


12. Centrifuge the capped WBC tube at 400-450 g for 5 minutes (alternatively, 150 g for 8 minutes) and discard all but 0.5-1.0 mL of the supernate to cover the cells.
*Cell clumping can occur and was found in about one fifth of the [[leukocyte]] preparations examined. The presence of [[red blood cells]] or [[plasma]] will lead to reduced [[leukocyte]] labeling efficiency. [[Transferrin]] in plasma competes for indium In 111 oxyquinoline.


13. Add 5.0 mL Sodium Chloride (0.9%) Injection, USP. Resuspend the cells by gentle swirling.
*After injection of labeled leukocytes into normal volunteers, about 30% of the dose is taken up by [[spleen]] and 30% by [[liver]], reaching a plateau at 2-48 hours after injection. No significant clearance of [[radioactivity]] is observed at 72 hours in these two organs. Pulmonary uptake is 4-7.5% at 10 minutes but is lost rapidly; pulmonary [[radioactivity]] is usually visible in scans only up to about 4 hours after injection.


14. With the shielded syringe, draw up approximately 22.2 MBq, 600 µCi indium In 111 oxyquinoline. Check the amount of radioactivity in a dose calibrator set for indium In 111 and record for labeling efficiency calculations.
*The human [[biodistribution]] studies in three normal subjects injected with indium In 111 oxyquinoline labeled leukocytes indicate a biexponential disappearance of indium In 111 from the blood when monitored for up to 72 hours. Between 9.5 to 24.4% of the injected dose remains in whole blood and clears with a biological half-time of 2.8 to 5.5 hours. The remainder (13-18%) clears from blood with a biological half-time of 64 to 116 hours.


Parenteral drug products should be inspected visually for particulate matter and discoloration before administration.
*Elimination from the body of injected indium In 111 oxyquinoline is probably mainly through decay to stable cadmium since only a negligible amount (less than 1%) of the dose is excreted in feces and urine in 24 hours.


15. In several additions, add the indium In 111 oxyquinoline to the WBC tube, gently swirling after each addition.
*Clearance from whole blood and biological distribution can vary considerably with the individual recipient, the condition of the injected cells and labeling techniques used.


16. Set the lab timer for 15 minutes and allow the capped WBC tube to incubate. Swirl the cell preparation several times during the incubation.
*Release of [[radioactivity]] from the labeled cells is about 3% at 1 hour and 24% at 24 hours.


17. With a sterile plastic syringe, add half of the saved LPP (or about 8 mL) from the LPP tube. Cap and gently swirl the contents of WBC tube to resuspend the cells.
*Clearance from liver and spleen, for the purpose of calculating the radiation dose, is assumed to be equal to the physical half-life of indium In 111 (67.2 hours).
<!--Nonclinical Toxicology-->
|nonClinToxic======Carcinogenesis, Mutagenesis, Impairment of Fertility=====


18. Centrifuge the WBC tube at 450 g for 5 minutes (or 150 g for 8 minutes). Decant supernatant into the wash tube leaving behind about 0.5 mL of the supernate to cover the cells.
*Although earlier studies suggested that oxyquinoline (oxine) might have carcinogenic potential, recent studies have found no evidence of [[carcinogenicity]] in either rats or mice given oxyquinoline in feed at concentrations of 1,500 or 3,000 ppm for 103 weeks.


19. Assay the activity in the WBC tube and in the wash tube in a dose calibrator and record.
*It has been reported that human [[lymphocytes]] labeled with recommended concentrations of indium In 111 oxyquinoline showed chromosome aberrations consisting of gaps, breaks and exchanges that appear to be [[radiation]] induced. At 555 kBq/107, 15 µCi/107 [[lymphocytes]] 93% of the cells were reported to be abnormal. The oncogenic potential of such [[lymphocytes]] has not been studied. It has been reported that the radiation dose to 108 leukocytes is 9 × 104 mGy (0.9 × 104 rads) from 18.5 MBq, 500 µCi.


20. With a sterile plastic syringe add the remaining LPP to the cell button and gently resuspend by swirling. With a sterile syringe fitted with a 19 gauge needle, resuspend the cells by drawing the cells up into the syringe and expressing the suspension against the tube gently once or twice. Alternatively, draw up the cells into a syringe fitted with the filtered 19 gauge needle, and replace the needle with an unfiltered 19 or 20 gauge needle.
*Studies have not been performed to evaluate whether indium In 111 oxyquinoline affects [[fertility]] in male or female laboratory animals or humans.
<!--Clinical Studies-->
|clinicalStudies=There is limited information regarding <i>Clinical Studies</i> of {{PAGENAME}} in the drug label.


21. Reserve in the WBC tube a minimum amount of white cell suspension for a WBC count. A microscopic examination should also be completed to observe for clumping. Draw up the patient's dose (7.4 to 18.5 MBq, 200-500 µCi) and check the syringe in the dose calibrator. Record the measurement.
<!--How Supplied-->
|howSupplied=*Indium In 111 oxyquinoline solution is supplied in a vial as a single use only product containing 37 MBq, 1.0 mCi in 1.0 mL aqueous solution at the calibration date stated on the label. Vials are packaged in individual lead shields.
NDC 17156-021-01


==QUALITY CONTROL==
*The contents of the vial are radioactive and adequate shielding and handling precautions must be maintained.


It is generally advantageous to record any observations on cell abnormalities (e.g., cell clumping). A trypan blue exclusion test may also be performed.
*This preparation is approved for use by persons licensed by the Illinois Emergency Management Agency pursuant to 32 IL. Adm. Code Section 330.260(a) and 335.4010 or equivalent licenses of the Nuclear Regulatory Commission or an Agreement State.  


It is recommended that the preparation be used within one hour of labeling (See Precautions).
<!--Patient Counseling Information-->
|storage=*Indium In 111 oxyquinoline solution should be stored at room temperature (15-25°C, 59-77°F).


==How is Indium Oxyquinoline Supplied==
*Indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]] should preferably be reinjected within one hour of labeling. The labeled cells may be stored at room temperature (15-25°C, 59-77°F) for up to three hours following completion of the cell labeling procedure. Reinjection of indium In 111 oxyquinoline labeled [[autologous]] [[leukocytes]] more than 5 hours after initial blood drawing is not recommended.


Indium In 111 oxyquinoline solution is supplied in a vial as a single use only product containing 37 MBq, 1.0 mCi in 1.0 mL aqueous solution at the calibration date stated on the label. Vials are packaged in individual lead shields.
*Sterile technique must be used throughout the collection, labeling and re-injection procedures.


(NDC 17156-021-01)
|fdaPatientInfo=There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.


The contents of the vial are radioactive and adequate shielding and handling precautions must be maintained.
<!--Precautions with Alcohol-->
|alcohol=* Alcohol-{{PAGENAME}} interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.


This radiopharmaceutical is licensed by Illinois Department of Nuclear Safety for distribution to persons licensed pursuant to 32 Ill. Adm. Code 330.260 (a) and Part 335, Subpart E, 335.4010, or under equivalent licenses of an Agreement State or a Licensing State.
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<!--Pill Image-->


==SPECIAL HANDLING AND STORAGE==


Indium In 111 oxyquinoline solution should be stored at room temperature (15-25 °C, 59-77 °F).


Indium In 111 oxyquinoline labeled autologous leukocytes should preferably be reinjected within one hour of labeling. The labeled cells may be stored at room temperature (15-25 °C, 59-77 °F) for up to three hours following completion of the cell labeling procedure. Reinjection of indium In 111 oxyquinoline labeled autologous leukocytes more than 5 hours after initial blood drawing is not recommended.
<!--Label Display Image-->


Sterile technique must be used throughout the collection, labeling and re-injection procedures.
{{LabelImage
|fileName=Oxyquinoline01.png|This image is provided by the National Library of Medicine.
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[[Category:Drugs]]
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|fileName=Oxyquinoline02.png|This image is provided by the National Library of Medicine.
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{{WS}}
[[Category:Drug]]

Latest revision as of 16:40, 2 April 2015

Indium oxyquinoline
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aparna Vuppala, M.B.B.S. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Indium oxyquinoline is a Diagnostic Agent that is FDA approved for the diagnosis of radiolabeling autologous leukocytes. Indium In 111 oxyquinoline labeled leukocytes may be used as an adjunct in the detection of inflammatory processes to which leukocytes migrate, such as those associated with abscesses or other infection, following reinjection and detection by appropriate imaging procedures.. Common adverse reactions include hypersensitivity reaction.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Radiolabeling autologous leukocytes
  • Indium In 111 oxyquinoline labeled leukocytes may be used as an adjunct in the detection of inflammatory processes to which leukocytes migrate, such as those associated with abscesses or other infection, following reinjection and detection by appropriate imaging procedures. The degree of accuracy may vary with labeling techniques and with the size, location and nature of the inflammatory process.
  • Indium In 111 oxyquinoline labeled leukocyte imaging is not the preferred technique for the initial evaluation of patients with a high clinical probability of an abscess in a known location. Ultrasound or computed tomography may provide a better anatomical delineation of the infectious process and information may be obtained more quickly than with labeled leukocytes. If localization by these techniques is successful, labeled leukocytes should not be used as a confirmatory procedure. If localization or diagnosis by these methods fails or is ambiguous, indium In 111 oxyquinoline labeled leukocyte imaging may be appropriate.
Dosing Information
  • Imaging is recommended at approximately 24 hours post injection. Typically, anterior and posterior views of the chest, abdomen and pelvis should be obtained with other views as required.
  • Aseptic procedures and a shielded syringe should be employed in the withdrawal of indium In 111 oxyquinoline from the vial. Similar procedures should be employed during the labeling procedure and the administration of the labeled leukocytes to the patient. The user should wear waterproof gloves during the entire procedure. The patient's dose should be measured by a suitable radioactivity calibration system immediately before administration. At this time, the leukocyte preparation should be checked for gross clumping and red blood cell contamination.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Indium oxyquinoline in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Indium oxyquinoline in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding FDA-Labeled Use of Indium oxyquinoline in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Indium oxyquinoline in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Indium oxyquinoline in pediatric patients.

Contraindications

  • None known.

Warnings

  • Due to radiation exposure, indium In 111 oxyquinoline labeled leukocytes could cause fetal harm when administered to pregnant women. If this radiopharmaceutical is used during pregnancy, the patient should be informed of the potential hazard to the fetus.
  • Indium In 111 oxyquinoline labeled autologous leukocytes should be used only when the benefit to be obtained exceeds the risks involved in children under eighteen years of age owing to the high radiation burden and the potential for delayed manifestation of long-term adverse effects.
Precautions
  • Clumping of cells may produce focal accumulations of radioactivity in lungs which do not wash out in 24 hours and thus may lead to false positive results. This phenomenon can be detected by imaging the chest immediately after injection.
  • Chemotaxis of granulocytes deteriorates during storage and loss of chemotaxis may cause false negative scans. The spontaneous release of indium In 111 has been reported to range from about 3% at one hour to 24% at 24 hours. The maximum amount of time recommended between drawing the blood and reinjection should not exceed 5 hours. It is recommended that the labeled cells be used within one hour of preparation, if possible and in no case more than three hours after preparation.
  • Plasma and red cell contamination impairs labeling efficiency of leukocytes. Hemolyzed blood in labeled leukocytes may produce heart pool activity and should be avoided.
  • Cell aggregates of various degrees have been reported. Cell labeling techniques and standing of cell preparation may be contributing factors.
  • Nuclear medicine procedures involving withdrawal and reinjection of blood have the potential for transmission of blood borne pathogens. Procedures should be implemented to avoid administration errors and viral contamination of personnel during blood product labeling. A system of checks similar to the ones used for administering blood transfusions should be routine.
General
  • Strict aseptic techniques should be used to maintain sterility throughout the procedures for using this product.
  • Do not use after the expiration time and date (5 days after calibration time) stated on the label.
  • The contents of the vial are radioactive. Adequate shielding of the preparation must be maintained at all times.
  • Indium In 111 oxyquinoline, like other radioactive drugs, must be handled with care and appropriate safety measures should be used to minimize radiation exposure to clinical personnel. Care should also be taken to minimize radiation exposure to the patient consistent with proper patient management.
  • Radiopharmaceuticals should be used only by physicians who are qualified by training and experience in the safe use and handling of radionuclides and whose experience and training have been approved by the appropriate governmental agency authorized to license the use of radio-nuclides.

Adverse Reactions

Clinical Trials Experience

  • Sensitivity reactions (urticaria) have been reported. The presence of fever may mask pyrogenic reactions from indium In 111 oxyquinoline labeled leukocytes. The possibility of delayed adverse reactions has not been studied.

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Indium oxyquinoline in the drug label.

Drug Interactions

There is limited information regarding Indium oxyquinoline Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): C

  • Animal reproduction studies have not been conducted with Indium In 111 Oxyquinoline labeled leukocytes. It is also not known whether Indium In 111 Oxyquinoline labeled leukocytes can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
  • However, Indium Nitrate, a closely related compound, was teratogenic and embryopathic in hamsters. Indium In 111 Oxyquinoline labeled leukocytes should be given to a pregnant woman only if clearly needed.
  • Ideally, examinations using radiopharmaceuticals, especially those elective in nature, in women of childbearing capability should be performed during the first few (approximately ten) days following the onset of menses.


Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Indium oxyquinoline in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Indium oxyquinoline during labor and delivery.

Nursing Mothers

  • It is reported that indium 111 is secreted in human milk following administration of indium In 111 labeled leukocytes. Therefore, formula feedings should be substituted for breast feedings.

Pediatric Use

  • Safety and effectiveness in pediatric patients below age 18 have not been established

Geriatic Use

  • 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.

Gender

There is no FDA guidance on the use of Indium oxyquinoline with respect to specific gender populations.

Race

There is no FDA guidance on the use of Indium oxyquinoline with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Indium oxyquinoline in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Indium oxyquinoline in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Indium oxyquinoline in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Indium oxyquinoline in patients who are immunocompromised.

Administration and Monitoring

Administration

Monitoring

  • Image quality of radiolabeled leukocytes is indicative of efficacy

IV Compatibility

There is limited information regarding IV Compatibility of Indium oxyquinoline in the drug label.

Overdosage

There is limited information regarding Chronic Overdose of Indium oxyquinoline in the drug label.

Pharmacology

This image is provided by the National Library of Medicine.

Mechanism of Action

  • Indium forms a saturated (1:3) complex with oxyquinoline. The complex is neutral and lipid-soluble, which enables it to penetrate the cell membrane. Within the cell, indium becomes firmly attached to cytoplasmic components; the liberated oxyquinoline is released by the cell. It is thought likely that the mechanism of labeling cells with indium In 111 oxyquinoline involves an exchange reaction between the oxyquinoline carrier and subcellular components which chelate indium more strongly than oxyquinoline. The low stability constant of the oxyquinoline complex, estimated at approximately 10, supports this theory.

Structure

  • Indium In 111 oxyquinoline (oxine) is a diagnostic radiopharmaceutical intended for radiolabeling autologous leukocytes. It is supplied as a sterile, non-pyrogenic, isotonic aqueous solution with a pH range of 6.5 to 7.5. Each mL of the solution contains 37 MBq, 1 mCi of indium In 111 [no carrier added, >1.85 GBq/µg indium (>50 mCi/µg indium)] at calibration time, 50 µg oxyquinoline, 100 µg polysorbate 80, and 6 mg of HEPES (N-2-hydroxyethyl-piperazine-N'-2-ethane sulfonic acid) buffer in 0.75% sodium chloride solution. The drug is intended for single use only and contains no bacteriostatic agent. The radionuclidic impurity limit for indium 114m is not greater than 37 kBq, 1 µCi of indium 114m per 37 MBq, 1 mCi of indium In 111 at the time of calibration. The radionuclidic composition at expiration time is not less than 99.75% of indium In 111 and not more than 0.25% of indium In 114m/114.

Chemical name: Indium In 111 Oxyquinoline.

  • The precise structure of the indium In 111 oxyquinoline complex is unknown at this time. The empirical formula is (C9H6NO)3 In 111.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Indium oxyquinoline in the drug label.

Pharmacokinetics

  • Following the recommended leukocyte cell labeling procedure, approximately 77% of the added indium In 111 oxyquinoline is incorporated in the resulting cell pellet (which represents approximately 3-4 × 108 WBC).
  • Cell clumping can occur and was found in about one fifth of the leukocyte preparations examined. The presence of red blood cells or plasma will lead to reduced leukocyte labeling efficiency. Transferrin in plasma competes for indium In 111 oxyquinoline.
  • After injection of labeled leukocytes into normal volunteers, about 30% of the dose is taken up by spleen and 30% by liver, reaching a plateau at 2-48 hours after injection. No significant clearance of radioactivity is observed at 72 hours in these two organs. Pulmonary uptake is 4-7.5% at 10 minutes but is lost rapidly; pulmonary radioactivity is usually visible in scans only up to about 4 hours after injection.
  • The human biodistribution studies in three normal subjects injected with indium In 111 oxyquinoline labeled leukocytes indicate a biexponential disappearance of indium In 111 from the blood when monitored for up to 72 hours. Between 9.5 to 24.4% of the injected dose remains in whole blood and clears with a biological half-time of 2.8 to 5.5 hours. The remainder (13-18%) clears from blood with a biological half-time of 64 to 116 hours.
  • Elimination from the body of injected indium In 111 oxyquinoline is probably mainly through decay to stable cadmium since only a negligible amount (less than 1%) of the dose is excreted in feces and urine in 24 hours.
  • Clearance from whole blood and biological distribution can vary considerably with the individual recipient, the condition of the injected cells and labeling techniques used.
  • Release of radioactivity from the labeled cells is about 3% at 1 hour and 24% at 24 hours.
  • Clearance from liver and spleen, for the purpose of calculating the radiation dose, is assumed to be equal to the physical half-life of indium In 111 (67.2 hours).

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility
  • Although earlier studies suggested that oxyquinoline (oxine) might have carcinogenic potential, recent studies have found no evidence of carcinogenicity in either rats or mice given oxyquinoline in feed at concentrations of 1,500 or 3,000 ppm for 103 weeks.
  • It has been reported that human lymphocytes labeled with recommended concentrations of indium In 111 oxyquinoline showed chromosome aberrations consisting of gaps, breaks and exchanges that appear to be radiation induced. At 555 kBq/107, 15 µCi/107 lymphocytes 93% of the cells were reported to be abnormal. The oncogenic potential of such lymphocytes has not been studied. It has been reported that the radiation dose to 108 leukocytes is 9 × 104 mGy (0.9 × 104 rads) from 18.5 MBq, 500 µCi.
  • Studies have not been performed to evaluate whether indium In 111 oxyquinoline affects fertility in male or female laboratory animals or humans.

Clinical Studies

There is limited information regarding Clinical Studies of Indium oxyquinoline in the drug label.

How Supplied

  • Indium In 111 oxyquinoline solution is supplied in a vial as a single use only product containing 37 MBq, 1.0 mCi in 1.0 mL aqueous solution at the calibration date stated on the label. Vials are packaged in individual lead shields.

NDC 17156-021-01

  • The contents of the vial are radioactive and adequate shielding and handling precautions must be maintained.
  • This preparation is approved for use by persons licensed by the Illinois Emergency Management Agency pursuant to 32 IL. Adm. Code Section 330.260(a) and 335.4010 or equivalent licenses of the Nuclear Regulatory Commission or an Agreement State.

Storage

  • Indium In 111 oxyquinoline solution should be stored at room temperature (15-25°C, 59-77°F).
  • Indium In 111 oxyquinoline labeled autologous leukocytes should preferably be reinjected within one hour of labeling. The labeled cells may be stored at room temperature (15-25°C, 59-77°F) for up to three hours following completion of the cell labeling procedure. Reinjection of indium In 111 oxyquinoline labeled autologous leukocytes more than 5 hours after initial blood drawing is not recommended.
  • Sterile technique must be used throughout the collection, labeling and re-injection procedures.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Patient Counseling Information of Indium oxyquinoline in the drug label.

Precautions with Alcohol

  • Alcohol-Indium oxyquinoline interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Indium oxyquinoline Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Indium oxyquinoline Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

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