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likely [10:14 GBq). Transient ovarian failure has been observed in females after sodium iodide I 131 treatment. Radiation-induced thyroiditis: Sodium iodide I 131 may cause thyroiditis (with gland enlargement) and thyroid hormone release, particularly if used in the treatment of hyperthyroidism. Thyroiditis may cause or worsen hyperthyroidism, and may lead to thyroid storm. When treating hyperthyroidism, consider pretreatment with antithyroid medication to help deplete thyroid hormone content within the gland. Discontinue antithyroid medication at least 3 days prior to sodium iodide I 131 administration. Consider beta-blocker therapy prior to sodium iodide I 131 administration to minimize the risk of hyperthyroidism and thyroid storm. Thyroiditis may result in gland enlargement with neck tenderness and swelling, pain with swallowing, sore throat, and cough; may require management with anti-inflammatory medications or analgesics. Radiation toxicities: Radiation-induced toxicities, including dose-dependent fatalities, have been reported following sodium iodide I 131 therapy. Postmarketing reports have identified an increased risk for neoplasia, as well as a risk of hematopoietic suppression (transient neutropenia/thrombocytopenia; onset 3 to 5 weeks). Salivary and lacrimal gland toxicity is relatively common and may manifest as conjunctivitis, xerophthalmia, epiphora, sialadenitis, and xerostomia. Thyroid-stimulating hormone/thyroid enlargement: Enhanced thyroid-stimulating hormone (TSH) secretion (eg, following discontinuation of antithyroid medications, or the administration of TSH to enhance sodium iodide I 131 uptake) may cause thyroid enlargement and obstructive complications of the trachea, esophagus, or blood vessels in the neck. Evaluate patients at high risk of obstructive complications prior to preparative treatments known to cause thyroid enlargement. Disease-related concerns: Hyperthyroidism/thyrotoxic cardiac disease: May be aggravated by radiation thyroiditis; consider pre- and post-treatment with antithyroid agents and/or beta-blockers. Hypochloremia: May increase thyroid uptake of sodium iodide I 131 . Renal impairment: Sodium iodide I 131 is eliminated predominantly renally; patients with renal impairment may have decreased clearance and increased radiation exposure. Sodium iodide I 131 is dialyzable and hemodialysis may be used to decrease total body radiation exposure. Evaluate renal function prior to treatment. Nephrosis may increase thyroid uptake of sodium iodide I 131 . Concurrent drug therapy issues: Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Iodine/thyroid medications: Concomitant use of iodine, thyroid, or antithyroid medications may interfere with the uptake of radioiodide; medications should be discontinued for an appropriate time prior to dosing. Special populations: Elderly: Elderly patients are more likely to have decreased renal function and comorbid conditions; may require close evaluation, dose selection, and follow-up compared with younger patients. When treating hyperthyroidism in geriatric patients at risk of developing cardiac complications, pre- and post-treatment with antithyroid drugs and/or beta-blockers may minimize the risk of excessive post-treatment hyperthyroidism due to radiation-induced thyroiditis. Pediatric: The thyroid gland may be more sensitive to the effects of sodium iodide I 131 in pediatric patients; safety and efficacy have not been established. Special handling: Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and healthcare personnel. Use only under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority. Unwanted radiation exposure can occur from handling and administration of radiopharmaceuticals or from contaminated waste products, including urine and feces. Patients must be instructed in measures to minimize exposure of others. Other warnings/precautions: Appropriate use: Patients should be adequately hydrated prior to and for at least 1 week following administration. Frequent voiding is recommended to enhance radioiodide excretion. Stimulate salivary flow (gum or sugar-free candy) to reduce radiation exposure to salivary glands. Avoid close contact with others (especially pregnant women and children) and contamination of other persons or the environment with body fluids. Monitoring Parameters Thyroid function tests (TSH, free T 4 , total T 3 ) within 1 to 2 months post-treatment and at 4 to 6 week intervals for 6 months, or until hypothyroid and stable on thyroid hormone replacement (Graves disease, toxic multinodular goiter, toxic adenoma) (Ross 2016) Pregnancy Risk Factor X Pregnancy Considerations Use is contraindicated in pregnancy. Iodine-131 crosses the placenta and may cause severe and irreversible hypothyroidism in neonates. Pregnancy should be ruled out prior to therapy. Use of 2 effective methods of contraception is recommended (for females and males) during treatment and for at least 12 months following administration; if additional iodide I 131 therapy or radionuclide imaging is anticipated, the use of 2 effective methods of contraception may be necessary for at least 1 year. Elective diagnostic procedures should be delayed until after delivery (Parker 2004). Patient Education Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?) Patient may experience nausea or vomiting. Have patient report immediately to prescriber angina, tachycardia, dizziness, shortness of breath, difficulty swallowing, painful swallowing, chills, pharyngitis, severe loss of strength and energy, dry eyes, dry mouth, persistent cough, neck tenderness, or neck edema (HCAHPS). Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients. Next Interactions Print this page Add to My Med List More about sodium iodide-i-131 Side Effects During Pregnancy or Breastfeeding Drug Interactions Support Group 0 Reviews Add your own review/rating Drug class: antithyroid agents Consumer resources Sodium iodide i 131 (Advanced Reading) Professional resources I-131 Mini (FDA) Sodium Iodide I 131 (FDA) Sodium Iodide, i-123 (FDA) Other brands: Iodotope , Hicon , i3odine Max Related treatment guides Hyperthyroidism Diagnosis and Investigation Thyroid Cancer] Drug Status Rx Availability Prescription only X Pregnancy Category Not for use in pregnancy N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Sodium iodide-i-131 Rating No Reviews - Be the first! 10 /10 No Reviews - Be the first! 10 Rate it! Manufacturer Cardinal Health Drug Class Antithyroid agents Therapeutic radiopharmaceuticals Related Drugs antithyroid agents methimazole , Tapazole , propylthiouracil , potassium iodide , SSKI therapeutic radiopharmaceuticals strontium-89 chloride , Iodotope , samarium sm 153 lexidronam , iodine i 131 tositumomab , Metastron , Hicon Thyroid Cancer Armour Thyroid , Nature-Throid , Nexavar , Adriamycin , doxorubicin , sorafenib , NP Thyroid , Lenvima , More... Hyperthyroidism methimazole , Tapazole , propylthiouracil , reserpine , potassium iodide , SSKI , More... Diagnosis and Investigation glucagon , arginine , Lexiscan , mannitol , L-Arginine , GlucaGen , Tubersol , inulin , More... exercise session


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