Flutemetamol F-18 (Vizamyl) is a radiopharmaceutical agent that is used to estimate the amount of beta-amyloid plaques using PET scan in patients who are being evaluated for Alzheimer disease and other conditions resulting in a gradual cognitive decline.

Flutemetamol F-18 Uses:

• Brain imaging:

  • It is inidicated to estimate beta-amyloid plaques density in the brain via using PET (positron emission tomography) imaging in adult patients who are being evaluated for Alzheimer disease and cognitive impairment.
  • It is used as an adjunct to other diagnostic evaluations.

Note: A positive scan does not reliably establish a diagnosis of AD or other cognitive disorder.

Flutemetamol F-18 (Vizamyl) Dose in Adults

Flutemetamol F-18 (Vizamyl) Dose in Brain imaging:

• IV: 5 mCi (185 MBq);
• Maximum dose: 20 mcg mass dose

Use in Children:

Not indicated

Pregnancy Risk Factor C

• Animal reproduction studies have not included any study of the drug.
• Women with reproductive potential must evaluate their pregnancy status.
• Elective diagnostic procedures must be postponed until the delivery.

Flutemetamol F-18 use during breastfeeding:

• It is unknown if the drug will be excreted into breastmilk.
• Elective diagnostic procedures must be postponed until the delivery.
• Lactating mothers must discontinue breastfeeding temporarily for 24 hours, and then discard breastmilk.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Side Effects of Flutemetamol F-18 (Vizamyl):

• Cardiovascular:

  • Flushing
  • Increased blood pressure

• Central nervous system:

  • Dizziness
  • Headache

• Gastrointestinal:

  • Nausea

Contraindications to Flutemetamol F-18 (Vizamyl):

Patients who have had an allergic reaction to any drug or component of the formulation, such as polysorbate 80, should not be treated.

Warnings and precautions

• Hypersensitivity

  • Within minutes of administering the drug, allergic reactions such as shortness or flushing of the nose and throat have been reported.
  • Patients who have never had to be exposed to the drug may experience allergic reactions.
  • Any emergency that may arise after the drug is administered should be treated promptly with the appropriate medication.

• Malignancy

  • Patients are exposed to radiation during the procedure. Radiation exposure is a major factor in the risk of developing malignancies.

Monitoring Parameters:

None mentioned

How to administer Flutemetamol F-18 (Vizamyl)?

IV:

• It is administered as a single intravenous bolus injection (within 30 - 40 seconds) in a total volume of 10 ml or less. The injection is followed by a saline flush of 5 to 15 ml.
• Patients are instructed to increase the uptake of water after the administration of the drug to minimize the radiation to the bladder.
• Patients are instructed to void before and after the imaging and frequently during the first 24 hours after the administration of the drug .
• Since, it is a radiopharmaceutical, it should be handled with full precautions.
• Waterproof gloves should be worn. Effective shielding including lead glass syringes should be used when handling the drug and during its administration.

Mechanism of action of Flutemetamol F-18 (Vizamyl):

It crosses the blood brain border and binds with b-amyloid plaques, generating a positron signal which is detected by a PET scanner.

Distribution:

• • It diffuses through the blood-brain barrier.
  • Positive scans show a steady increase in signals between the time the drug is administered and 30 minutes afterward.
  • For up to two hours, stable values can be observed afterward.

Excretion:

• Renal: ~37%;
• Hepatobiliary: ~52%

International Brand Names of Flutemetamol F-18:

• Vizamyl
• Vazamyl

Flutemetamol F-18 Brand Names in Pakistan:

No Brands Available in Pakistan.