Gallium (Sup67 / Supga) Citrate

What it is and how it works

Gallium-67 (half-life about 78 hours) behaves as an iron analogue: after intravenous injection it binds to transferrin and accumulates in tissues with increased transferrin receptor expression, in inflammatory cells and bacteria (via lactoferrin and siderophores) and in certain tumours. Its gamma emissions are imaged by planar scintigraphy or SPECT.

Indications

Scintigraphic localisation of inflammatory and infective lesions (e.g. fever of unknown origin, osteomyelitis, sarcoidosis, interstitial lung disease) and of certain tumours such as Hodgkin’s and non-Hodgkin’s lymphoma, now largely replaced by PET techniques where available.

Dosage and administration (summary)

Dosing is individualised according to the imaging protocol and administered by nuclear medicine specialists as a single intravenous injection, with imaging typically at 24–72 hours or later.

Contraindications

Hypersensitivity to the active substance or excipients.

Warnings and precautions

Physiological uptake in liver, bone marrow, bowel, salivary and lacrimal glands and breast (especially during lactation) can obscure lesions, and bowel preparation may be needed; recent chemotherapy, blood transfusion, gadolinium contrast or iron therapy may alter biodistribution. Breastfeeding should be interrupted for a prolonged period according to radiation protection guidance.

Pregnancy

Generally avoided in pregnancy unless essential, because of fetal radiation exposure.

Storage and supply

Store at room temperature (below 25 °C) in appropriate radiation shielding and use within the shelf-life stated on the label.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.