• Lutetium Lu 177 dotatate comes as a liquid which should be administered intravenously using a particular technique by trained healthcare personnel.
• Lutetium Lu 177 dotatate is slowly infused along with 0.9% sodium chloride using specific precautions and technique. It is necessary to flush 25 ml of 0.9% sodium chloride following the lutetium Lu 177 dotatate infusion.
• An infusion of amino acid solution containing L-lysine and L-arginine should be administered beginning 30 minutes before and continuing for at least 3 hours after lutetium Lu 177 dotatate administration. Anti-emetics (medications to prevent vomiting) should be administered 30 minutes before administering the amino acid solution.
• Aseptic technique and appropriate safety measures such as wearing waterproof gloves radiation shielding are necessary while administering lutetium Lu 177 dotatate. To reduce the exposure to radiation, tongs can be used while handling the vial.
• Long-acting octreotide 30mg should be administered intramuscularly between 4 to 24 hours after each lutetium Lu 177 dotatate administration, while short-acting octreotide can be administered in between as needed. Somatostatin analogues like octreotide reduce the secretion by the tumor and thereby reduce symptoms like diarrhea and flushing caused by the tumor.
• However, a long-acting somatostatin analogue should not be used at least four weeks before, or short-acting octreotide should not be administered at least 24 hours before a dose of lutetium Lu 177 dotatate, since it could interfere with the treatment.
• Once the treatment with lutetium Lu 177 dotatate is completed, the patient should receive long-acting octreotide 30 mg intramuscularly every 4 weeks for up to 18 months since the start of treatment. The treatment with long-acting octreotide can be stopped early in case the disease continues to progress.
• Dose modifications are recommended in patients with adverse reactions either by reducing the dose or if necessary, by permanently discontinuing the treatment.
• Allergy to lutetium Lu 177 dotatate
• Pregnancy and breastfeeding
• Severe liver or kidney disorder
• Children
• Lutetium Lu 177 dotatate is slowly infused along with 0.9% sodium chloride using specific precautions and technique. It is necessary to flush 25 ml of 0.9% sodium chloride following the lutetium Lu 177 dotatate infusion.
• An infusion of amino acid solution containing L-lysine and L-arginine should be administered beginning 30 minutes before and continuing for at least 3 hours after lutetium Lu 177 dotatate administration. Anti-emetics (medications to prevent vomiting) should be administered 30 minutes before administering the amino acid solution.
• Aseptic technique and appropriate safety measures such as wearing waterproof gloves radiation shielding are necessary while administering lutetium Lu 177 dotatate. To reduce the exposure to radiation, tongs can be used while handling the vial.
• Long-acting octreotide 30mg should be administered intramuscularly between 4 to 24 hours after each lutetium Lu 177 dotatate administration, while short-acting octreotide can be administered in between as needed. Somatostatin analogues like octreotide reduce the secretion by the tumor and thereby reduce symptoms like diarrhea and flushing caused by the tumor.
• However, a long-acting somatostatin analogue should not be used at least four weeks before, or short-acting octreotide should not be administered at least 24 hours before a dose of lutetium Lu 177 dotatate, since it could interfere with the treatment.
• Once the treatment with lutetium Lu 177 dotatate is completed, the patient should receive long-acting octreotide 30 mg intramuscularly every 4 weeks for up to 18 months since the start of treatment. The treatment with long-acting octreotide can be stopped early in case the disease continues to progress.
Dosage & When it is to be taken
• The recommended dosage of lutetium Lu 177 dotatate in adults is 7.4 GBq (200 mCi) administered every eight weeks for a total of 4 doses.• Dose modifications are recommended in patients with adverse reactions either by reducing the dose or if necessary, by permanently discontinuing the treatment.
When it is not to be taken (Contraindications)
Lutetium Lu 177 dotatate should not be used in the following conditions:• Allergy to lutetium Lu 177 dotatate
• Pregnancy and breastfeeding
• Severe liver or kidney disorder
• Children
