Technetium 99m mebrofenin is a radio-diagnostic imaging product used for the diagnosis of hepatobiliary disorders. At the recommended dosage, it does not possess any pharmacokinetic activities.

Technetium Tc-99m mebrofenin Uses:

• Imaging agent:

  • Hepatobiliary imaging agent

Technetium 99m Dose in Adults

Technetium 99m Dose in the treatment of Hepatobiliary imaging:

• IV (based on 70 kg patient): 2 to 5 mCi (74 to 185 MBq)

Technetium 99m Dose in Childrens

Not mentioned.

Pregnancy Risk Factor CIt is insoluble and opaque to xrays.

• Studies on animal reproduction have not been done.
• Technetium Tc99m can be detected within fetal tissue. The amount depends on the formulation, route of administration and the duration of the pregnancy.
• The likelihood of fetal side effects from radiopharmaceuticals depends on how much the drug is absorbed and how long the pregnancy has been.
• Radiopharmaceuticals that are used in therapeutic procedures at high doses are more likely than to cause harm to fetal health.
• Modifying a medically necessary diagnostic procedure to reduce fetal risk is possible.
• It is best to delay elective diagnostic procedures until after delivery.
• Women with childbearing potential should determine their pregnancy status.

Tc-99m mebrofenin use during breastfeeding:

• Breast milk contains Technetium Tc99m.
• Manufacturer recommends using formula instead of breast-feeding formula.
• Technetium Tc99m mebrofenin information has not yet been found.
• However, one source suggests that breastfeeding should be stopped immediately after technetium 99m compounds are administered for 12 hours.
• Women with a stable milk supply should continue to breastfeed after the administration of radiopharmaceuticals.
• The amount of technetium Tc99m excreted into colostrum can vary widely and information is scarce.
• Therefore, it is difficult to make recommendations regarding early breast-feeding (Mountford 1989; Rubow 1994).
• It is important to delay elective diagnostic procedures until after breastfeeding has stopped.
• It may be necessary to comply with all regulatory requirements regarding recordkeeping and instructions to patients, depending on the dose.

Tc-99m Dose in Kidney Disease:

No dosage adjustment provided in the manufacturer’s labeling.

Tc-99m Dose in Liver disease:

Serum bilirubin >1.5 mg/dL: 3 to 10 mCi (111 to 370 MBq)

Side effects of Technetium 99m:

• Dermatologic:

  • Skin rash
  • Urticaria

Contraindications to Tc-99m mebrofenin:

Hypersensitivity to Tc99m mebrofenin, or any other component of the formulation

Warnings and precautions

• Hypersensitivity reactions

  • Patients who receive multiple doses of medication may experience allergic reactions.

• Meperidine or morphine sulfate use:

  • Recent use of imaging agents may slow down intestinal transit, resulting in non-visualization.

• Hepatic impairment

  • Possible causes of delayed visualization or non-visualization.

Monitor:

Infusion reactions

How to administer Technetium Tc-99m mebrofenin?

IV:

• For IV administration.
• The test should be performed while the patient is fasting; avoid interference with opioids by delaying the study for 4 hours after the last dose.
• Radiopharmaceutical; use appropriate precautions for handling and disposal.

Mechanism of action of Tc-99m mebrofenin:

It is a radioactive diagnostic agent which decays by the isomeric transition to emit a photon that can be detected by imaging

It provides radiographic studies with a positive contrast.

The onset of action:

• Detectable in the hepatic duct and gallbladder within 10 to 15 minutes and in the intestinal tract within 30 to 60 minutes

Half-life elimination:

• 6.02 hours

Excretion:

• Urine (1% within 3 hours; 3% within 3 hours in patients with elevated serum bilirubin)

International Brands of Technetium Tc-99m mebrofenin:

• Bridatec
• Cholecis
• Cholediam
• Hibida

Technetium Tc-99m mebrofenin Brand Names in Pakistan:

No Brands Available in Pakistan.