Florbetapir F-18 (intravenous)

Overview

Used for various purposes, a positron emission tomography (PET) scan produces 3D images of the tissue inside the body. Sometimes used to diagnose certain types of cancers, PET scans are also used to confirm the presence of Alzheimer's disease and/or other types of cognitive impairments.

In order to be effective, however, a radioactive agent, such as Florbetapir F-18, must be present in the affected area. When injected into the patient's body, Florbetapir F-18 acts as a dye. As Florbetapir F-18 contains radioactive tracers, it is highlighted during a PET scan. As a result, doctors are able to view how the Florbetapir F-18 moves around the body and can determine how well the body's tissues and organs are working.

When PET scans are used to diagnose Alzheimer's disease, Florbetapir F-18 binds to the peptide beta-amyloid. When Alzheimer's disease is present, beta-amyloid tends to clump together and form plaques. It is these plaques which disrupt communication signals between brain cells, which causes some of the common symptoms associated with the condition.

Once Florbetapir F-18 has bound to beta-amyloid in the brain, a PET scan can be used to determine whether the beta-amyloid has formed plaques and, if so, where exactly they are. Although PET scans using Florbetapir F-18 can be used in the diagnostic process, they are not generally used in isolation.

Whilst amyloid plaques in the brain are associated with Alzheimer's disease, it is possible for individuals to have plaques present in the brain but not to exhibit any symptoms of Alzheimer's disease. Due to this, PET scanning with Florbetapir F-18 is normally used in conjunction with other tests in order to diagnose Alzheimer's disease and/or other cognitive conditions.

Conditions Treated

  • Diagnostic tool used in PET scanning

Type Of Medicine

  • Radiopharmaceutical

Side Effects

Generally, Florbetapir F-18 is administered prior to a PET scan and patients may notice some side effects once the medication has been delivered. In many cases, these are relatively mild and should diminish as the medication begins to wear off. If the patient isn't troubled by the following side effects, for example, they may not need medical intervention:

  • Back pain
  • Pain, irritation or bleeding at the site of the injection
  • Fear
  • Chills
  • Bone or muscle pain
  • Feeling cold
  • Neck pain
  • Nausea
  • Unusual weakness or tiredness
  • Trouble sleeping
  • Feeling of warmth
  • Change in taste
  • Hives, welts, rash on the skin
  • Loss of taste
  • Itching
  • Redness of the neck, arms, face and, sometimes, the upper chest

Although these side effects will not necessarily require medical treatment, patients should always seek help if they are concerned about the presence of any side effects. In addition to this, patients should notify their doctor or nurse if they experience any of the following side effects after Florbetapir F-18 has been administered:

  • Blurred vision
  • Headache
  • Dizziness
  • Pounding in the ears
  • Nervousness
  • Fast or slow heartbeat

Whilst the above side effects are fairly rare, they may require urgent medical intervention. Due to this, patients should obtain immediate medical assistance if they notice these side effects occurring. Similarly, patients should obtain medical advice if they exhibit any other side effects which are not listed here.

Dosage

Prior to carrying out a PET scan, a healthcare practitioner will administer the Florbetapir F-18 into the patient's vein. Typically, a dose between 13.5-51 mCi/mL is used when Florbetapir F-18 is being used to assist in the diagnosis of Alzheimer's disease.

After the intravenous application of Florbetapir F-18, a PET scan can normally be carried out within 30-50 minutes. Due to this, patients should be given Florbetapir F-18 some time before the scan is due to be carried out.

As Florbetapir F-18 is administered intravenously, it will always be given by a trained healthcare professional. Due to this, patients will not have to calculate their own dose of Florbetapir F-18, prepare the solution or administer the medication.

Potential Drug Interactions

Patients should be aware that drugs, medicines and diagnostic agents can sometimes interact with one another. Due to this, it may not be appropriate to use Florbetapir F-18 if patients are taking certain other medicines. This may include over-the-counter medications, supplements and/or vitamins.

Patients will need to inform their physician if they are taking any other substances before Florbetapir F-18 is administered and before the PET scan is carried out. In addition to this, patients should seek medical advice before taking any prescription medicines, over-the-counter medicines, supplements and/or vitamins once the Florbetapir F-18 has been administered.

Warnings

Before undergoing any medical testing, patients should discuss their medical history and current diagnosis with their physician. There are some conditions and medicines which can affect the results of medical tests and doctors will need to be aware of what the patient is taking or has been diagnosed with before administering Florbetapir F-18 or carrying out a PET scan.

When the PET scan is being carried out, it is vital that the patient has enough Florbetapir F-18 in their system. If too little Florbetapir F-18 is used, it may not highlight the beta-amyloid effectively and the results cannot, therefore, be used for diagnostic purposes.

Once the intravenous application of Florbetapir F-18 has begun, patients will be monitored closely. This enables doctors to ensure that the patient has an adequate dose of Florbetapir F-18 and that they are not suffering from any adverse effects.

When patients are given Florbetapir F-18, they are being exposed to radiation. Doctors will aim to keep the patient's radiation exposure as low as possible to reduce any risks associated with the use of nuclear medicine. However, patients should discuss this risk with their doctor before Florbetapir F-18 is administered if they are concerned about the use of a radiopharmaceutical.

As Alzheimer's disease usually affects older patients, the effects of Florbetapir F-18 on pediatric patients is unknown. Due to this, pediatric patients are not generally given Florbetapir F-18 prior to PET scanning.

As a radioactive agent, Florbetapir F-18 could cause harm to an unborn fetus if it is administered to a pregnant patient. The level of harm caused by Florbetapir F-18 is likely to depend on the stage of fetal development and/or the amount of radioactive agent administered to the patient.

Due to the potential risks, pregnant patients should not be given Florbetapir F-18, unless it is absolutely necessary. If the use of Florbetapir F-18 is deemed necessary, patients should have the risks explained to them before Florbetapir F-18 is administered.

It is not yet known whether Florbetapir F-18 can be passed to an infant via breastmilk. Due to the possibility of harm occurring, patients who are breastfeeding may not be given Florbetapir F-18 or may be advised to suspend nursing for at least 24 hours after being given Florbetapir F-18. Patients should always check with their physician before returning to breastfeeding if they have been given Florbetapir F-18 or an alternative radioactive agent.

Before undergoing PET scanning or being given Florbetapir F-18, patients or their caregivers should inform doctors of any allergies they suffer from. This includes allergies to medicines, foods, animals, dyes and/or preservatives. In rare cases, patients may develop an allergic reaction to Florbetapir F-18. As serious reactions can be life-threatening, patients should obtain immediate medical help if they display the following symptoms:

  • Wheezing
  • Itching
  • Hives
  • Trouble breathing
  • Hoarseness
  • Trouble swallowing
  • Swelling of the hands, mouth, throat, lips, tongue and/or face

As Florbetapir F-18 should only be administered in a clinical setting, patients should find it relatively easy to obtain medical help if they experience an allergic reaction once the agent has been administered.

Storage

When Florbetapir F-18 is stored, it should be kept in its original container. As a radioactive agent, Florbetapir F-18 packaging should contain radioactive shielding as this can help to prevent harm occurring to anyone who comes into contact with it.

In addition to this, Florbetapir F-18 should usually be stored at a temperature of 25?C (77?F). However, temperatures between 15?-30?C (59?-86?F) may be acceptable in some cases.

As Florbetapir F-18 is given to patients intravenously, it will only be administered in a hospital or clinical setting. Furthermore, Florbetapir F-18 should only be handled by staff who are trained and qualified in the preparation and administration of nuclear medicines.

Due to this, patients will not be required to store Florbetapir F-18 at home and will not need to manage the application of Florbetapir F-18 at any time.

Summary

Although there is not currently a cure for Alzheimer's disease, early detection can be crucial to the successful treatment of the condition. If patients are diagnosed quickly enough, medications can be used to halt the progression of the disease and this can significantly reduce the cognitive decline associated with the condition.

The use of Florbetapir F-18 is, therefore, extremely important when it comes to diagnosing Alzheimer's disease. By enabling physicians to identify plaques within the brain, Florbetapir F-18 can help to confirm whether Alzheimer's disease is present. Whilst Florbetapir F-18 and PET scanning is not used alone to diagnose the condition, it can be used alongside other diagnostic tools to confirm whether the patient has Alzheimer's disease and, if so, how advanced the disease has become.