Fluoride ion F-18



Fluoride ion F-18 is a diagnostic radiopharmaceutical agent used as a bone imaging agent to delineate areas of altered osteogenesis.

Brand Names
Sodium Fluoride F-18
Generic Name
Fluoride ion F-18
DrugBank Accession Number

Sodium Fluoride F 18 Injection is a positron emitting radiopharmaceutical, no-carrier added. It contains radioactive fluoride F 18 that is used for diagnostic purposes in conjunction with positron emission tomography (PET) imaging and is administered by intravenous injection. Its primary indication is for bone imaging. Increased deposition around joints can occur in arthritis and following trauma and increased deposition in bone has been noted around fracture sites, in osteomyelitis, fibrous dysplasia, spondylitis tuberculosa, and Paget's disease. No adverse reactions have been reported.

Small Molecule
Average: 18.0015
Monoisotopic: 18.001486247
Chemical Formula
  • (18F)-Fluoride
  • 18F-Fluoride
  • Fluoride-18 anion



18F is used as a bone imaging agent to define areas of altered osteogenic activity. It has been indicated for back pain and otherwise unexplained bone pain, child abuse, abnormal radiographic or laboratory findings, osteomyelitis, trauma, inflammatory and degenerative arthritis, avascular necrosis. Osteonecrosis of the mandible, condylar hyperplasia, and metabolic bone disease are also among the indications for fluoride imaging.

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Associated Conditions
Contraindications & Blackbox Warnings
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Deposition of 18F fluoride in bone appears to be primarily a function of blood flow to the bone and the efficiency of the bone in extracting the 18F from the blood perfusing the bone. Increased fluorine F 18 ion deposition around joints can occur in arthritis or following trauma; increased deposition has also been documented in bone around fracture sites, in osteomyelities, fibrous dysplasia, spondylitis tuberculosa, Paget's disease, hyperstosis frontalis interna, myositis, ossificans, and in rapidly growing epiphyses. The tendency for fluorine F 18 ions to accumulate in the vicinity of primary and metastatic malignancy in bone has proven clinically useful in detection of such lesions

Mechanism of action

18F-fluoride is a highly sensitive bone-seeking PET tracer used for detection of skeletal abnormalities. The uptake mechanism of 18F-fluoride has better pharmacokinetic characteristics (compared to other elements) including faster blood clearance and 2-fold higher uptake in bone. Uptake of 18F-fluoride reflects blood flow and bone remodeling.


Following intravenous administration, Sodium Fluoride F 18 injection provides fluorine F 18 ions that rapidly equilibrate, primarily within the extracellular fluid space.

Volume of distribution

0.5-0.7 L/Kg

Protein binding

Fluorine F 18 ions do not appear to be bound to serum proteins


First, the 18F- exchanges for an OH- ion on the surface of the hydroxyapatite matrix of bone and this is followed by migration of the 18F- into the crystalline matrix of the bone where it is retained until the bone is remodelled.

Route of elimination

Fluorine F 18 ions are rapidly eliminated via the renal system. 20% or more of the fluorine F 18 ions are cleared from the body in the urine within the first 2 hours after intravenous administration.


110 min.


Renal clearance for fluoride is 48-147 mL/min, depending upon urinary flow and pH.

Adverse Effects
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The lethal dose of NaF to the average adult has been estimated to be between 32 to 64 mg fluoride/kg body weight.

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.
Not Available
Food Interactions
No interactions found.


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Product Ingredients
IngredientUNIICASInChI Key
Sodium fluoride F-189L75099X6R22554-99-0PUZPDOWCWNUUKD-ULWFUOSBSA-M
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Sodium Fluoride F 18Injection, solution475 mCi/1mLIntravenousTriad Isotopes, Inc.2010-11-202010-11-20US flag
Sodium FluorideF 18 F 18Injection200 mg/1mLIntravenousChildren's Hospital Of Michigan2012-06-12Not applicableUS flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousSofie Co.2011-12-08Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousUcsf Radiopharmaceutical Facility2009-11-01Not applicableUS flag
Sodium Fluoride F 18Injection, solution200 mCi/1mLIntravenousJUBILANT DRAX IMAGE RADIOPHARMACIES, INC. DBA JUBILANT RADIOPHARMA2011-01-26Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousBAMF Health Inc.2022-12-06Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousEssential Isotopes LLC2011-01-01Not applicableUS flag
Sodium Fluoride F 18Injection, solution200 mCi/1mLIntravenousBiomedical Research Foundation Of Northwest Louisiana2015-01-22Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousHouston Cyclotron Partners Lp Dba Cyclotope2011-12-082020-05-11US flag
Sodium Fluoride F 18Injection600 mCi/1mLIntravenousTHE FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH2014-11-19Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousPrecision Nuclear Llc2011-01-01Not applicableUS flag
Sodium Fluoride F 18Injection200 mCi/1mLIntravenousNukeMed, Inc. dba SpectronRx2015-04-24Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Sodium Fluoride F 18Sodium fluoride F-18 (475 mCi/1mL)Injection, solutionIntravenousTriad Isotopes, Inc.2010-11-202010-11-20US flag
Sodium FluorideF 18 F 18Sodium fluoride F-18 (200 mg/1mL)InjectionIntravenousChildren's Hospital Of Michigan2012-06-12Not applicableUS flag


ATC Codes
V09IX06 — Sodium fluoride (18f)
Drug Categories
Chemical TaxonomyProvided by Classyfire
This compound belongs to the class of inorganic compounds known as homogeneous halogens. These are inorganic non-metallic compounds in which the largest atom is a nobel gas.
Inorganic compounds
Super Class
Homogeneous non-metal compounds
Homogeneous halogens
Sub Class
Not Available
Direct Parent
Homogeneous halogens
Alternative Parents
Not Available
Homogeneous halogen
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

CAS number
InChI Key


General References
  1. article [Link]
  2. drug label [Link]
  3. article [Link]
  4. article [Link]
PubChem Compound
PubChem Substance

Clinical Trials

Clinical Trials
4CompletedPreventionAtherosclerosis / Cardiovascular Disease (CVD) / Molecular Imaging1
3CompletedDiagnosticBone Metastases1
3CompletedDiagnosticBone Metastases From Breast or Prostate Cancer1
2CompletedDiagnosticNeoplasms of the Prostate1
2Enrolling by InvitationDiagnosticMetastatic Prostate Cancer / Neoplasms of the Prostate / Prostate Cancer1
2RecruitingTreatmentHereditary leiomyomatosis renal cell carcinoma / Papillary Renal Cell Carcinoma / Renal Cell Carcinoma (RCC) / Sporadic Papillary Renal Cell Carcinoma / Stage III Renal Cell Cancer AJCC v8 / Stage IV Renal Cell Cancer AJCC v81
2Unknown StatusDiagnosticArtery Stenosis, Carotid1
1CompletedDiagnosticMetastatic Prostate Cancer1
1TerminatedDiagnosticHormone Resistant Prostate Cancer / Metastatic Carcinoma of the Prostate / Metastatic Malignant Neoplasm in the Bone1


Not Available
Not Available
Dosage Forms
Tablet0.25 mg
Injection, solutionParenteral2 GBq/ml
Injection, solutionIntravenous
InjectionIntravenous10 mCi/1mL
InjectionIntravenous600 mCi/1mL
InjectionIntravenous91.5 mCi/1mL
Injection, solutionIntravenous200 mCi/1mL
Injection, solutionIntravenous475 mCi/1mL
InjectionIntravenous200 mCi/1mL
Injection, solutionIntravenous10-200 mCi/ML
InjectionIntravenous200 mg/1mL
Not Available
Not Available


Experimental Properties
Not Available
Predicted Properties
pKa (Strongest Acidic)3.17Chemaxon
Physiological Charge-1Chemaxon
Hydrogen Acceptor Count0Chemaxon
Hydrogen Donor Count0Chemaxon
Polar Surface Area0 Å2Chemaxon
Rotatable Bond Count0Chemaxon
Refractivity0.87 m3·mol-1Chemaxon
Polarizability0.44 Å3Chemaxon
Number of Rings0Chemaxon
Rule of FiveYesChemaxon
Ghose FilterNoChemaxon
Veber's RuleYesChemaxon
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

Drug created at November 30, 2015 19:10 / Updated at June 12, 2020 16:52