Radiopharmaceuticals drug interactions: a critical review

Abstract

Radiopharmaceuticals play a critical role in modern medicine primarily for diagnostic purposes, but also for monitoring disease progression and response to treatment. As the use of image has been increased, so has the use of prescription medications. These trends increase the risk of interactions between medications and radiopharmaceuticals. These interactions which have an impact on image by competing with the radiopharmaceutical for binding sites for example can lead to false negative results. Drugs that accelerate the metabolism of the radiopharmaceutical can have a positive impact (i.e. speeding its clearance) or, if repeating image is needed, a negative impact. In some cases, for example in cardiac image among patients taking doxirubacin, these interactions may have a therapeutic benefit. The incidence of drug-radiopharmaceuticals adverse reactions is unknown, since they may not be reported or even recognized. Here, we compiled the medical literature, using the criteria of a systematic review established by the Cochrane Collaboration, on pharmaceutical-drug interactions to provide a summary of documented interactions by organ system and radiopharmaceuticals. The purpose is to provide a reference on drug interactions that could inform the nuclear medicine staff in their daily routine. Efforts to increase adverse event reporting, and ideally consolidate reports worldwide, can provide a critically needed resource for prevention of drug-radiopharmaceuticals interactions.

Drug Related Problems in Radio and Nuclear Pharmacy

“…Radiopharmaceutical plays a critical role in modern medicine primarily for the diagnostic purpose, but also for monitoring disease progression and response to treatment. 1 Radio pharmacy is integral part of clinical pharmacy so pharmaceutical care is applied in the specialty area of nuclear medicine. Clinical pharmacy and role of Radio pharmacy is in infancy.…”

Hospital Nuclear Pharmacy Survey: Preliminary Aspects In Brazil

“…Nuclear Medicine is nowadays well established and recognized by the medical community, and the use of radiopharmaceuticals for diagnose and therapy became regular procedures. [2]…”

“…[2] Currently, the USA, European Union, and Japan consider radiopharmacy as a regular branch of pharmacy, and the radiopharmacists as recognized members of the multidisciplinary staffs working in Nuclear Medicine. [3] Due to the lack of specific regulation, these professionals are not yet rightfully acknowledged in Brazil.…”

New Electrochemical Detection Strategies for Iodinated Compounds

“…Iodide from thyrostatic drugs, plays an important role in the protection of the thyroid gland against certain types of radiopharmaceuticals, because it modifies the kinetics of radioiodine in the thyroid and through this mechanism may also have a radio protective effect. Also a pre-treatment with thyrostatic medication lowers the effective half-life and uptake of radioiodine [5].…”