Gallium Citrate Ga-67 is a radiopharmaceutical agent that is used for diagnostic imaging purposes in patients with lymphomas and acute inflammatory conditions or infections.

Gallium citrate Ga-67 Uses:

• Diagnostic imaging:

  • It is used for identifying the presence and extent of Hodgkin disease, lymphoma, and acute inflammatory lesions.

Gallium Citrate Dose in Adults

Gallium Citrate Dose in the Diagnostic imaging: IV:

• Scintigraphy for inflammation or infection:

  • 4 to 6 mCi (150 to 220 MBq).

• Tumor scintigraphy:

  • 5 to 10 mCi (185 to 370 MBq).
• Manufacturer's labeling:
  • It may not reflect current clinical practice for dosing in prescribing information.

Gallium Citrate Dose in Children

Gallium Citrate Dose in Diagnostic imaging:

• Scintigraphy for inflammation or infection (off-label):

  • IV: 0.07 mCi/kg (2.6 MBq/kg), with a minimum of 0.5 mCi (18.5 MBq) or
  • alternatively for children >5 years:
    • 0.04 to 0.07 mCi/kg (1.5 to 2.6 MBq/kg).

Galium Citrate Pregnancy Risk Category: N (Not defined)

• Although animal reproduction studies have not been done, Ga67 could accumulate in the placenta.
• According to the manufacturer, women with reproductive potential should have optional diagnostic procedures performed within 10 days of their menstrual cycle.

Gallium citrate Ga-67 use during breastfeeding:

• Even non-lactating women can find Ga 67 in their breast tissue.
• One case reported that significant levels of the drug were found in breast milk after the drug was administered to a postpartum woman. This occurred ten days later.
• The volume of breast milk and the stage of breastfeeding will determine the actual drug concentration.
• Manufacturers recommend formula milk, but withhold breastfeeding. 
• To reduce drug exposure in infants, the manufacturer recommends discontinuing breastfeeding for 2 to 4 weeks following injection due to the drug's long half-life.

Dose in Kidney Disease:

• There are no dosage adjustments given on the manufactory’s label.

Dose in Liver disease:

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

Side effects of Gallium citrate:

• Dermatologic:

  • Rash

• Gastrointestinal:

  • Nausea

• Miscellaneous:

  • Hypersensitivity reactions

Contraindications to Gallium citrate Ga-67:

• The US manufacturer's labeling does not list any contraindications.
• Canadian labeling: Allergy to gallium citrate or any other component of the formulation.

Monitoring Parameters:

• Observe for extravasation and monitor for hypersensitivity reactions.

How to administer Gallium citrate Ga-67?

• It is a radiopharmaceutical agent that is intended for intravenous use only. Use appropriate precautions for handling and disposal.
• Effective radiation shielding and waterproof gloves are recommended when handling this radiopharmaceutical agent.
• Until the final imagings are received, the manufacturer suggests cleaning the bowel of radioactive substance and minimizing false-positive results (with a laxative and or enema)

Mechanism of action of Gallium citrate Ga-67:

• Galium citrate Ga67 is a radioactive diagnostic drug that is bound to soluble intracellular proteins and is stored in the lysosomes.
• The drug builds up at the site of infection, and it concentrates in metastatic and primary tumors.

Half-life elimination:

• Physical: 78.3 hours

Excretion:

• After 7 days:
  • Average whole-body retention is 65%,
  • urine 26%,
  • feces 9%

Gallium citrate Ga-67 Brand Names in Pakistan:

• No Brands Available in Pakistan.