Technetium Tc-99m oxidronate


Generic Name
Technetium Tc-99m oxidronate
DrugBank Accession Number

Technetium Tc-99m oxidronate, also known as 99mTc-methylene diphosphonate, is a radiopharmaceutical agent. A radiopharmaceutical is defined as a medicinal formulation containing radioisotopes that are used in major clinical areas for diagnosis and/or therapy.2 The radiopharmaceuticals based on technetium-99m are widely used for diagnostic purposes because 99mTc has a versatile chemistry which allows it to produce an extense variety of complexes with specific characteristics.3 These complexes are formed by the binding of 99mTc to metal atoms of an organic molecule. The group oxidronate falls into the category of diphosphonates whose structure allows them to bind to calcium.4 Thus, technetium Tc-99m oxidronate is a powerful detection tool for abnormal osteogenesis by skeletal scintigraphy.5 It was developed by Mallinkrodt nuclear and FDA approved on February 18, 1981.

Small Molecule
Average: 290.906
Monoisotopic: 290.865131083
Chemical Formula
  • 99mtc-HDP
  • Oxidronic acid 99mtc-complex
  • Technetium (99mTc) oxidronate
  • Technetium 99mtc oxidronate
  • Technetium Tc 99m oxidronate



Technetium Tc-99m oxidronate is indicated in adult and pediatric patients to be used in skeletal imaging for diagnosis of areas that can present altered osteogenesis. When administered intravenously, it is able to generate a clear image of the bones which allows the physician to diagnose any bone problem.6 It is important to point out that this drug has to be manipulated only under the service of a nuclear specialist.5 The approved indications for a bone scan are 1) visualization of tumor metastasis in bone, 2) osteomyelitis, 3) fracture, 4) stress fracture, 5) avascular necrosis, 6) osteoporosis and 7) prosthetic joint evaluation. From all the major indications, the detection of a metastatic disease is the most common because it presents a 95% of sensitivity and lesion detection can be done 6 months earlier than with X-ray studies.4

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Associated Conditions
Contraindications & Blackbox Warnings
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The technetium is generated in a molibdene generator. Technetium Tc-99m presents a reduction of gamma emission after 6 hours and it is considered a quasi-stable molecule.5 The visualization of bone lesions is possible since there is an altered uptake in areas of abnormal osteogenesis.4 The principal photon used for detection is the gamma-2 with an energy of 140.5 keV.5 Its use for bone examination should be performed 2 hours after initial injection with a recommended activity on the range of 370-740 MBq.8

Mechanism of action

The exact mechanism for bone uptake of technetium Tc-99m oxidronate is unknown. The most accepted mechanism is the localization of 99m-Tc on the surface of hydroxyapatite crystals of bone by chemisorption. Chemisorption is explained as a type of adsorption that involves a chemical reaction between the surface and the adsorbate in which new strong interactions form electronic bonds at the adsorbent surface.1 The presented chemisorption are regulated by the blood flow and blood concentration because it restrains the delivery of the agent in the uptake sites.4


Technetium Tc-99m oxidronate is rapidly absorbed and cleared from blood plasma to reach the skeleton.7 After 27 min of intravenous administration, a range of 45-50% of the technetium Tc-99m oxidronate is accumulated in the skeleton, reaching maximum accumulation at 1-hour post injection and remaining constant until 72 hours postinjection.8

Volume of distribution

The distribution of technetium Tc-99m oxidronate at 1-hour post injection is mainly in the bones and secondary in the liver and kidneys.3

Protein binding

The protein binding has been reported to be around 20-30% after 2-3 hours of intravenous administration.8


Technetium Tc-99m oxidronate is a diphosphonate. There have been reports showing that diphosphonates form very stable Tc(IV) complexes which provide them with a very high in vivo stability and a very low degradation.8

Route of elimination

It is recommended to empty bladder completely just prior to technetium Tc-99m oxidronate administration. It is as well recommended to drink abundant water and to empty bladder as often as possible to reduce radiation exposure in the bladder wall. The total radioactivity in blood between 5 min and 24 hours goes from 40% to 2.3% respectively. Technetium Tc-99m oxidronate whole body retention after 24 hours is a ratio of 36.6% which indicates that this drug, unlike other bone radiopharmaceuticals, presents a greater uptake. The glomerular filtration of technetium Tc-99m oxidronate can reach a 60% of the administered dose after 6 hours of the initial dose. The cumulative activity excreted in the urine after 24 hours is of approximately 59% suggesting a ratio of femur-to-muscle of 35.8


The elimination of technetium Tc-99m oxidronate is marked by the presence of three different half-times which are: 1) rapid phase of 3.5 min, 2) intermediate phase of 27 min and 3) slow phase of 144 min.8


During the first 24 hours of technetium Tc-99m oxidronate administration, it is observed a rapid clearance from blood and non-osseous tissues. The dosage gets accumulated in skeleton and urine.7

Adverse Effects
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There has not been performed long-term animal studies to evaluate carcinogenic potential or an effect in fertility in males or females.7

Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
AbacavirAbacavir may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Technetium Tc-99m oxidronate which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
AcrivastineTechnetium Tc-99m oxidronate may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
Adefovir dipivoxilAdefovir dipivoxil may decrease the excretion rate of Technetium Tc-99m oxidronate which could result in a higher serum level.
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Food Interactions
Not Available


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ATC Codes
V09BA01 — Technetium (99mtc) oxidronic acid
Drug Categories
Chemical TaxonomyProvided by Classyfire
This compound belongs to the class of organic compounds known as bisphosphonates. These are organic compounds containing two phosphonate groups linked together through a carbon atoms.
Organic compounds
Super Class
Organic acids and derivatives
Organic phosphonic acids and derivatives
Sub Class
Direct Parent
Alternative Parents
Organic phosphonic acids / Organic transition metal salts / Organopnictogen compounds / Organophosphorus compounds / Organooxygen compounds / Organic oxides / Hydrocarbon derivatives
Aliphatic acyclic compound / Bisphosphonate / Hydrocarbon derivative / Organic oxide / Organic oxygen compound / Organic salt / Organic transition metal salt / Organooxygen compound / Organophosphonic acid / Organophosphorus compound
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

CAS number
InChI Key
[hydroxy(phosphono)methyl]phosphonic acid (⁹⁹Tc)technetium


General References
  1. Oura K., Lifshits G., Saranin A., Zotov V. and Katayama M. (2003). Surface science, an introduction. Springer.
  2. WHO [Link]
  3. IAEA [Link]
  4. Human health IAEA [Link]
  5. Doctissimo [Link]
  6. Pubmedhealth [Link]
  7. SNMjournals [Link]
  8. Tc-99m compounds [Link]
PubChem Compound
PubChem Substance
FDA label
Download (118 KB)
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Clinical Trials

Clinical Trials


Not Available
Not Available
Dosage Forms
Not Available
Not Available


Experimental Properties
melting point (°C)0ºC (reconstituted)'MSDS'
boiling point (°C)100ºC (reconstituted)'MSDS'
water solubilitySoluble'MSDS'
Radioactivity (mCi/mL)100000'MSDS'
Predicted Properties
Water Solubility13.5 mg/mLALOGPS
pKa (Strongest Acidic)0.75Chemaxon
pKa (Strongest Basic)-5Chemaxon
Physiological Charge-3Chemaxon
Hydrogen Acceptor Count7Chemaxon
Hydrogen Donor Count5Chemaxon
Polar Surface Area135.29 Å2Chemaxon
Rotatable Bond Count2Chemaxon
Refractivity29.72 m3·mol-1Chemaxon
Polarizability11.94 Å3Chemaxon
Number of Rings0Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleNoChemaxon
Predicted ADMET Features
Not Available


Mass Spec (NIST)
Not Available
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available


Pharmacological action
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
Uniprot ID
Uniprot Name
Serum albumin
Molecular Weight
69365.94 Da
  1. Tc-99m compounds [Link]

Drug created at September 30, 2015 16:50 / Updated at November 03, 2020 01:20