Radiogardase
Radiogardase Uses, Dosage, Side Effects, Food Interaction and all others data.
Radiogardase is described as a deep blue pigment that is produced when the oxidation of ferrous ferrocyanide salts occurs. It contains ferric hexacyanoferrate(II) in a cubic lattice crystal structure. It is insoluble in water but also tends to form a colloid thus can exist in either colloidal or water-soluble form, and an insoluble form. It is orally administered for clinical purposes to be used as an antidote for certain kinds of heavy metal poisoning, such as thallium and radioactive isotopes of caesium. Radiogardase is included in the World Health Organization Model List of Essential Medicines as a specific antidote used in poisonings to provide symptomatic and supportive treatment. It was also administered in individuals exposed to 137-Cs+ during Goiânia accident, one of the worst radioactive contamination incidents that occured in Brazil, 1983.
Radiogardase is an insoluble radioactive metals chelating agent and absorbent. It acts by ion-exchange, adsorption, and mechanical trapping within the crystal structure and has a very high affinity for radioactive and non-radioactive cesium and thallium. The antidote therapy greatly minimizes the extent of contamination and reduces the half life of radioactive isotopes which have relatively long physicall half life and uniform tissue distribution. Data suggest that in humans, Radiogardase can reduce cesium’s half-life by approximately 43% and reduce total body burdens by significantly increasing the feces-to-urine excretion ratio .
| Trade Name | Radiogardase |
| Generic | Prussian blue |
| Prussian blue Other Names | Berlin blue, Ferric ferrocyanide, Ferric hexacyanoferrate, Ferrocin, Iron(III) ferrocyanide, Paris blue, Parisian blue, Prussian blue insoluble |
| Weight | 500mg, |
| Type | Oral capsule |
| Formula | C18Fe7N18 |
| Weight | Average: 859.239 Monoisotopic: 859.599884 |
| Groups | Approved |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States, |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Radiogardase is a chelating agent used to reduce the extent of systemic contamination with radioactive cesium and/or radioactive or non-radioactive thallium.
Indicated for treatment of patients with known or suspected internal contamination with radioactive cesium and/or radioactive or non-radioactive thallium to increase their rates of elimination.
Radiogardase is also used to associated treatment for these conditions: Internal contamination caused by radioactive or non-radioactive thallium, Internal contamination with radioactive cesium
How Radiogardase works
Radiogardase binds cesium and thallium isotopes in the gastrointestinal tract after ingestion or excreted in the bile by the liver, therby reduces gastrointestinal reabsorption into the enterohepatic circulation. It serves as an ion exchanger for univalent cations and it preferentially binds to cesium or thallium as its affinity for cations increases as the ionic radius of the cation increases . Radiogardase exchanges potassium for cesium or thallium at the surface of the crystal in the intestinal lumen. The insoluble complex is excreted without being absorbed from the intestinal walls. Insoluble prussian blue decreases the half life of cesium by 33% and from 3.8 to 2.2 days for thallium . The rate of cesium and thallium elimination is proportional to the dose and duration of prussian blue.
Toxicity
Mild cases of hypokalemia have been reported as prussian blue may bind other electrolytes found in the gastrointestinal tract. Gastrointestinal symptoms include abdominal pain or distension. Constipation may occur resulting in further decreased gastrointestinal motility and increased reabsorption and exposure time to radioisotopes, but may may be treated with a fiber based laxative and/or a high fiber diet. Oral dose that results in acute toxicity in mouse, rat and rabbit is >8000mg/kg. Based on reported adverse events and mechanism of action, possible overdose symptoms may include obstipation, obstruction, or severe decrease in electrolytes.
Food Interaction
No interactions found.Volume of Distribution
Histopathological examination of different organs showed no deposits of prussian blue after oral administration of insoluble prussian blue .
Elimination Route
It is poorly or not absorbed from the gastrointestinal tract walls after oral ingestion. Systemic absorption is assumed to be insignificant, with minimal release of cyanide from the complex. A small amount (approximately 2%) of the hexacyanoferrate ion was absorbed after oral ingestion of prussian blue but with no signs of decomposition. Radiogardase is not systemically bioavailable .
Clearance
The clearance from the body depends on the gastrointestinal tract transit time .
Elimination Route
It predominantly depends on fecal excretion, and does not depend on renal elimination. Based on animal data, 99% of a single dose of 40 mg of labeled insoluble Radiogardase was excreted unchanged in feces .
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