Florbetaben F18 (intravenous)

This medication is an injectable radiopharmaceutical treatment which is used in the procedure called positron emission tomography, which scans the brain for potential cognitive issues.

Overview

Florbetaben F18 is a radioactive pharmaceutical which must be used under the direct supervision of a doctor who is familiar with the properties and usage of nuclear medications. It is a molecular imaging solution which has the capability of binding to certain receptors in the brain to make brain scans easier to analyze.

The goal of using Florbetaben F18 is to estimate the beta-amyloid neuritic plaque density in a patient who is experiencing some degree of cognitive impairment. A scan with a very low level of neuritic plaques is considered 'a negative' response and indicates that Alzheimer's Disease is probably not the reason for the patient's impairment. If there is a moderate to heavy incidence of neuritic plaques, that would be considered 'a positive' scan and would indicate a likelihood that cognitive impairment has been caused by Alzheimer's Disease.

This drug cannot be used to forecast the development of mental disorders of any kind, because it can only detect the neuritic plaque concentration that prevails at the moment the PET scan is being conducted, and cannot predict any diminution or increase.

Condition Treated

  • Use in positron emission tomography (PET) for diagnosis of mental issues

Type Of Medicine

  • Radiopharmaceutical

Side Effects

There has not been a high incidence of side effects reported by patients being treated with Florbetaben F18, although that may be attributable to the fact that it is not a medication which is administered on a regular schedule. Since it is only used in conjunction with PET scans and laboratory tests of cognitively impaired patients, it does not have the opportunity to build up to any appreciable level in the body.

However, there have been some side effects reported in association with the site of injections administered to some patients. People have experienced these side effects in very mild form as well as in fairly severe form, but since reactions vary from patient to patient, it cannot be predicted how any single individual might be affected by Florbetaben F18. The most notable side effects which have historically been experienced by patients include some or all of the following:

  • Injection site pain or swelling
  • Injection site irritation, sometimes accompanied by itching
  • Injection site erythema

In all known cases of side effects experienced by patients being injected with this medication, the side effects disappeared all on their own within a few days of appearance, and without the need for medical treatment.

Dosage

It is recommended that any patient being injected with Florbetaben F18 have the injection administered into one of the large veins of one arm, to be followed by a saline flush. It is necessary to deliver this medication intravenously in order to avoid irradiation, as well as any traces which might show up during imaging and cause a distortion of results.

This is one of those rare times in the administration of a medication where a standard dosage can be considered appropriate for most patients because the only impact it is expected to have inside the body is to bind itself to certain receptors for imaging purposes, and not to produce any medical effects. This being the case, a dosage of 300 MBq, with a ceiling dosage of 30 mcg, should be administered intravenously in a single bolus, with a total volume of no more than 10 mL.

Before administering Florbetaben F18 to any patient, the solution should be checked for possible discoloration, as well as for any particles which may be present. If either of these two conditions are present, the solution should not be used at all and an alternate vial should be chosen for usage.

Interactions

For most medications, it is highly advisable to have an understanding of any other drugs which might interact with the one you're taking, because there could be adverse side effects imparted to a patient during these interactions. It's also true that the effectiveness of your medication can be impacted by interaction with other medicines you are currently taking. In the case of Florbetaben F18, however, this is not a medication which you will be ingesting but is instead used to highlight the results of imaging scans being performed on you.

Since you do not actively ingest this medication and it does not enter your bloodstream, it will not interact with any other medication you might be taking. There are no known interactions of other drugs on the effectiveness of Florbetaben F18, with regard to its effectiveness as an imaging agent.

Warnings

The kinds of warnings or precautions associated with Florabetaben F18 fall into two different categories: those precautions which relate to patients, and those precautions which relate to medical personnel conducting the imaging tests. With regard to the potential for misinterpretation or errors in imaging results, medical personnel should be aware of all of the following precautions:

  • There is a potential for error in the estimation of new neuritic amyloid plaque density of the brain during interpretation of the images, so it's important that interpretation occurs separately from the known clinical information for any given patient
  • Errors can occur in situations where there is pronounced atrophy in the brain which inhibits the ability to interpret between gray and white matter on a scan
  • There is a potential for errors to occur due to trace motions which can distort the images
  • It should be borne in mind that all imaging results depict the status of brain neuritic amyloid plaques only at the precise moment of imaging, and cannot in any way predict development in the future.

With regard to precautions and warnings that are more specifically related to the patient, the following should be observed:

  • Since Florabetaben F18 is a drug in the class of radiopharmaceuticals, it has the potential to contribute to a patient's cumulative exposure to radiation over time, and this can increase the risk of cancer developing
  • All possible safety measures need to be taken for the welfare of both medical personnel and the patient being imaged, so as to minimize any exposure to radiation
  • It is not currently known whether Florabetaben F18 causes any specific harm to a fetus when the drug is administered to a woman who is pregnant
  • It is not currently known whether this medication has any effect on a woman's reproductive system
  • All radiopharmaceutical drugs can potentially cause harm to a fetus, which makes it highly advisable to consider the possible risks and rewards from administering this drug to a pregnant woman
  • The potential for harm to a fetus will depend on the precise stage of development for that fetus, as well as the dosage of Florabetaben F18 being administered
  • It is currently unknown whether or not Florabetaben F18 is passed on to nursing infants through breast milk
  • There is a potential for radiation exposure to be included in breast milk nursed by an infant
  • It is highly advisable to have a nursing mother discontinue breastfeeding for at least 24 hours prior to being treated with Florabetaben F18, and for at least 24 hours following the procedure
  • If need be, a woman's breasts can be pumped several days prior to treatment and sufficient breast milk can be stored for delivery to an infant while the treatment period is in progress
  • Pediatric patients should not be treated with Florabetaben F18
  • Geriatric patients have shown no particular harm when treated with Florabetaben F18, and in fact, the majority of patients who are imaged using this drug are seniors
  • The potential for an overdose of this medication is extremely low, since only low dosages are administered to patients for imaging, and these are always administered by qualified medical personnel
  • In the event of any kind of radiation overdose with Florabetaben F18, any crisis can be averted by simply increasing the elimination of the radionuclide which is resident in the body by inducing more frequent elimination.

Storage

This medication must be stored in its original container at all times, since it is a radiopharmaceutical, and the packaging has shielding which will prevent exposure during handling. It must be kept in a room temperature setting at around 77 degrees Fahrenheit, although temporary differences are allowable, as long as the range of temperatures remains between 36 and 108 degrees Fahrenheit.

Summary

Florabetaben F18 is a drug belonging to the class of drugs known as radiopharmaceuticals, and as such it must be handled with great care at all times, in order to avoid radiation harm to either medical handlers or patients. It is primarily used in brain imaging tests, to determine whether a cognitively impaired patient is suffering from Alzheimer's Disease, or whether there is another source for the impairment.

It is an injectable medication which is not absorbed into the bloodstream, but which remains in the brain and binds to certain receptors there, so as to facilitate imaging scans that follow. Since it is not ingested, there are few interactions with other drugs and very few associated side effects other than those which might occur at the site of an injection.