Fludeoxyglucose (18F)

Identification

Summary

Fludeoxyglucose (18F) is a radiopharmaceutical agent used for positron emission tomography (PET) imaging in oncology, cardiology, and neurology.

Generic Name
Fludeoxyglucose (18F)
DrugBank Accession Number
DB09502
Background

Fludeoxyglucose F 18 Injection is a positron emitting radiopharmaceutical containing no-carrier added radioactive 2-deoxy-2-[18F]fluoro-D-g1ucose, which is used for diagnostic purposes in conjunction with Positron Emission Tomography (PET). It is administered by intravenous injection.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 181.15
Monoisotopic: 181.061586121
Chemical Formula
C6H11FO5
Synonyms
  • (18F)-FDG
  • 18-F FDG
  • 18F-FDG
  • Fludeoxyglucose (18F)
  • Fludeoxyglucose F 18
  • Fludeoxyglucose F-18
  • Fludeoxyglucose, F-18
  • Fluorine (18F) fludeoxyglucose

Pharmacology

Indication

The uptake of 18F-FDG by tissues is a marker for the tissue uptake of glucose, which in turn is closely correlated with certain types of tissue metabolism. Fludeoxyglucose F 18 Injection is indicated in positron emission tomography (PET) imaging for assessment of abnormal glucose metabolism to assist in the evaluation of malignancy in patients with known or suspected abnormalities found by other testing modalities, or in patients with an existing diagnoses of cancer.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Fludeoxyglucose F 18 Injection is rapidly distributed to all organs of the body after intravenous administration. After background clearance of Fludeoxyglucose F 18 Injection, optimal PET imaging is generally achieved between 30 to 40 minutes after administration. In cancer, the cells are generally characterized by enhanced glucose metabolism partially due to (1) an increase in the activity of glucose transporters, (2) an increased rate of phosphorylation activity, (3) a reduction of phosphatase activity or, (4) a dynamic alteration in the balance among all these processes. However, glucose metabolism of cancer as reflected by Fludeoxyglucose F 18 accumulation shows considerable variability. Depending on tumor type, stage, and location, Fludeoxyglucose F 18 accumulation may be increased, normal, or decreased. Also, inflammatory cells can have the same variability of uptake of Fludeoxyglucose F 18. In the heart, under normal aerobic conditions, the myocardium meets the bulk of its energy requirements by oxidizing free fatty acids. Most of the exogenous glucose taken up by the myocyte is converted into glycogen. However, under ischemic conditions, the oxidation of free fatty acids decreases, exogenous glucose becomes the preferred myocardial substrate, glycolysis is stimulated, and glucose taken up by the myocyte is metabolized immediately instead of being converted into glycogen. Under these conditions, phosphorylated Fludeoxyglucose F 18 accumulates in the myocyte and can be detected with PET imaging. Normally, the brain relies on anaerobic metabolism. In epilepsy, the glucose metabolism varies. Generally, during a seizure glucose metabolism increases. Interictally, the seizure focus tends to be hypometabolic.

Mechanism of action

Fludeoxyglucose F 18 is a glucose analog that concentrates in cells that rely upon glucose as an energy source, or in cells whose dependence on glucose increases under pathophysiological conditions. Fludeoxyglucose F 18 is transported through the cell membrane by facilitative glucose transporter proteins and is phosphorylated within the cell to [18F] FDG-6- phosphate by the enzyme hexokinase. Once phosphorylated it cannot exit until it is dephosphorylated by glucose-6-phosphatase. Therefore, within a given tissue or pathophysiological process, the retention and clearance of Fludeoxyglucose F 18 reflect a balance involving glucose transporter, hexokinase and glucose-6- phosphatase activities. When allowance is made for the kinetic differences between glucose and Fludeoxyglucose F 18 transport and phosphorylation (expressed as the “lumped constant” ratio), Fludeoxyglucose F 18 is used to assess glucose metabolism. In comparison to background activity of the specific organ or tissue type, regions of decreased or absent uptake of Fludeoxyglucose F 18 reflect the decrease or absence of glucose metabolism. Regions of increased uptake of Fludeoxyglucose F 18 reflect greater than normal rates of glucose metabolism.

Absorption

Fludeoxyglucose F 18 Injection is rapidly distributed to all organs of the body after intravenous administration.

Volume of distribution

Fludeoxyglucose F 18 Injection is rapidly distributed to all organs of the body after intravenous administration.

Protein binding

The extent of binding of Fludeoxyglucose F 18 to plasma proteins is not known.

Metabolism

Fludeoxyglucose F 18 is transported into cells and phosphorylated to [18F]-FDG-6-phosphate at a rate proportional to the rate of glucose utilization within that tissue. [18F]-FDG-6-phosphate presumably is metabolized to 2-deoxy-2-[18F] fluoro-6-phospho-Dmannose ([18F]FDM-6-phosphate). Fludeoxyglucose F 18 Injection may contain several impurities (e.g., 2-deoxy-2-chloro-D-glucose (ClDG)). Biodistribution and metabolism of C1DG are presumed to be similar to Fludeoxyglucose F 18 and would be expected to result in intracellular formation of 2-deoxy-2-chloro-6-phospho-D-glucose (C1DG-6-phosphate) and 2-deoxy-2-chloro-6-phospho-D-mannose (ClDM-6-phosphate). The phosphorylated deoxyglucose compounds are dephosphorylated and the resulting compounds (FDG, FDM, C1DG, and ClDM) presumably leave cells by passive diffusion.

Route of elimination

Fludeoxyglucose F 18 is cleared from most tissues within 24 hours and can be eliminated from the body unchanged in the urine.

Half-life

10-13 minutes

Clearance

Fludeoxyglucose F 18 and related compounds are cleared from non-cardiac tissues within 3 to 24 hours after administration. Clearance from the cardiac tissue may require more than 96 hours

Adverse Effects
Adverseeffects
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Toxicity

Overdoses of Fludeoxyglucose F 18 Injection have not been reported.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

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.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Fludeoxyglucose (18F) which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AcrivastineAcrivastine may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
Adefovir dipivoxilAdefovir dipivoxil may decrease the excretion rate of Fludeoxyglucose (18F) which could result in a higher serum level.
Interactions
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Food Interactions
  • Take on an empty stomach. When using Fludeoxyglucose (18F) in oncology or neurology, avoid eating for 4-6 hours before Fludeoxyglucose (18F) administration.
  • Take with food. Consuming food or beverages containing 50-75 grams of glucose just before the administration of Fludeoxyglucose (18F) may be beneficial in the setting of cardiology imaging.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Fludeoxyglucose F 18Injection, solution475 mCi/1mLIntravenousTriad Isotopes, Inc.2010-11-202010-11-20US flag
Fludeoxyglucose F18Injection300 mCi/1mLIntravenousFeinstein Institute For Medical Research2005-08-19Not applicableUS flag
Fludeoxyglucose F18Injection400 mCi/1mLIntravenousTHE FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH2005-08-19Not applicableUS flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Fludeoxyglucose F 18Injection40 mCi/1mLIntravenousKettering Medical Center2011-12-08Not applicableUS flag
Fludeoxyglucose F 18Injection, solution100 mCi/1mLIntravenousHamamatsu/Queen’s PET Imaging Center, LLC2011-11-14Not applicableUS flag
Fludeoxyglucose F 18Injection, solution300 mCi/1mLIntravenousMassachusetts General Hospital2011-10-30Not applicableUS flag
Fludeoxyglucose F 18Injection500 mCi/1mLIntravenousNukeMed, Inc. dba SpectronRx2015-04-24Not applicableUS flag
Fludeoxyglucose F 18Injection300 mCi/1mLIntravenousNCM-USA Bronx LLC2015-01-07Not applicableUS flag
Fludeoxyglucose F 18Injection, solution300 mCi/1mLIntravenousJUBILANT DRAX IMAGE RADIOPHARMACIES, INC. DBA JUBILANT RADIOPHARMA2010-11-20Not applicableUS flag
Fludeoxyglucose F 18Injection0.5 Ci/1mLIntravenousNorthland Nuclear Medicine2019-01-31Not applicableUS flag
Fludeoxyglucose F 18Injection, solution200 mCi/1mLIntravenousPetnet Solutions, Inc.2008-07-29Not applicableUS flag
Fludeoxyglucose F 18Injection500 mCi/1mLIntravenousHot Shots Nm, Llc Dba Midwest Positron Technology, Lc2014-08-24Not applicableUS flag
Fludeoxyglucose F 18Injection, solution200 mCi/1mLIntravenousPharmalogic Puerto Rico, Inc.2021-06-01Not applicableUS flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Fludeoxyglucose F 18Fludeoxyglucose (18F) (475 mCi/1mL)Injection, solutionIntravenousTriad Isotopes, Inc.2010-11-202010-11-20US flag

Categories

ATC Codes
V09IX04 — Fludeoxyglucose (18f)
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as beta-hydroxy aldehydes. These are organic compounds containing an aldehyde substituted with a hydroxy group on the second carbon atom.
Kingdom
Organic compounds
Super Class
Organic oxygen compounds
Class
Organooxygen compounds
Sub Class
Carbonyl compounds
Direct Parent
Beta-hydroxy aldehydes
Alternative Parents
Secondary alcohols / Fluorohydrins / Polyols / Primary alcohols / Organofluorides / Organic oxides / Hydrocarbon derivatives / Alkyl fluorides
Substituents
Alcohol / Aliphatic acyclic compound / Alkyl fluoride / Alkyl halide / Beta-hydroxy aldehyde / Fluorohydrin / Halohydrin / Hydrocarbon derivative / Organic oxide / Organofluoride
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
2-deoxy-2-fluoro-aldehydo-D-glucose, 2-deoxy-2-((18)F)fluoro-D-glucose (CHEBI:49136)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
0Z5B2CJX4D
CAS number
63503-12-8
InChI Key
AOYNUTHNTBLRMT-MXWOLSILSA-N
InChI
InChI=1S/C6H11FO5/c7-3(1-8)5(11)6(12)4(10)2-9/h1,3-6,9-12H,2H2/t3-,4+,5+,6+/m0/s1/i7-1
IUPAC Name
(2R,3S,4R,5R)-2-(¹⁸F)fluoro-3,4,5,6-tetrahydroxyhexanal
SMILES
[H]C(=O)[C@H]([18F])[C@@H](O)[C@H](O)[C@H](O)CO

References

General References
  1. Tragardh M, Moller N, Sorensen M: Methodologic Considerations for Quantitative 18F-FDG PET/CT Studies of Hepatic Glucose Metabolism in Healthy Subjects. J Nucl Med. 2015 Sep;56(9):1366-71. doi: 10.2967/jnumed.115.154211. Epub 2015 Jul 9. [Article]
  2. Mega MS, Dinov ID, Porter V, Chow G, Reback E, Davoodi P, O'Connor SM, Carter MF, Amezcua H, Cummings JL: Metabolic patterns associated with the clinical response to galantamine therapy: a fludeoxyglucose f 18 positron emission tomographic study. Arch Neurol. 2005 May;62(5):721-8. [Article]
  3. Perani D, Bressi S, Testa D, Grassi F, Cortelli P, Gentrini S, Savoiardo M, Caraceni T, Fazio F: Clinical/metabolic correlations in multiple system atrophy. A fludeoxyglucose F 18 positron emission tomographic study. Arch Neurol. 1995 Feb;52(2):179-85. [Article]
  4. FDA Label [Link]
PubChem Compound
68614
PubChem Substance
347827867
ChemSpider
61878
RxNav
1362737
ChEBI
49136
ChEMBL
CHEMBL1808698
ZINC
ZINC000100079041
Wikipedia
Fluorodeoxyglucose_(18F)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Enrolling by InvitationDiagnosticBrain Imaging / Whole Body Imaging1
4TerminatedBasic ScienceAbdominal Aortic Aneurysms (AAA)1
4TerminatedTreatmentAsthma1
3RecruitingDiagnosticHistiocytosis1
3RecruitingDiagnosticMultiple Myeloma (MM)1
2Active Not RecruitingDiagnosticCigarette Smoking Behavior / Lung, Carcinoma / Solitary Pulmonary Nodules1
2Active Not RecruitingTreatmentEGFR Gene Amplification / EGFR Gene Mutations / Glioblastoma Multiforme (GBM) / Recurrent Glioblastoma / Supratentorial Glioblastoma / TP53 wt Allele1
2Active Not RecruitingTreatmentEpendymomas1
2Active Not RecruitingTreatmentStage III Non-Small Cell Lung Cancer AJCC v7 / Stage IIIA Non-Small Cell Lung Cancer AJCC v7 / Stage IIIB Non-Small Cell Lung Cancer AJCC v71
2CompletedDiagnosticAdvanced Non Small Cell Lung Cancer (NSCLC) / B-Cell Neoplasm / Breast Cancer Stage IIIc / Carcinoma Breast Stage IV / Estrogen Receptor Negative / HER2/Neu Negative / Progesterone Receptor Negative / Renal Cell Cancer Metastatic / Stage III Mesothelioma / Stage III Renal Cell Cancer / Stage IIIA Breast Cancer / Stage IIIA Non Small Cell Lung Cancer / Stage IIIB Non Small Cell Lung Cancer / Stage IV Mesothelioma / Stage IV Renal Cell Cancer / Triple Negative Breast Carcinoma1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, solutionParenteral
InjectionIntravenous
Injection, solutionIntravenous
InjectionIntravenous0.5 Ci/1mL
InjectionIntravenous20 mCi/1mL
InjectionIntravenous240 mCi/1mL
InjectionIntravenous40 mCi/1mL
Injection, solutionIntravenous100 mCi/1mL
Injection, solutionIntravenous300 mCi/1mL
Injection, solutionIntravenous475 mCi/1mL
InjectionIntravenous200 mCi/1mL
InjectionIntravenous500 mCi/1mL
Injection, solutionIntravenous200 mCi/1mL
Injection, solutionIntravenous500 mCi/1mL
InjectionIntravenous12.5 mCi/ml
InjectionIntravenous100 mCi/1mL
InjectionIntravenous300 mCi/1mL
InjectionIntravenous400 mCi/1mL
Injection, solutionIntravenous0.3 Ci/1mL
Injection, solutionIntravenous; Parenteral185 MBq/ml
Injection, solution
Injection, solutionIntravenous; Parenteral250 MBq/ml
Injection, solutionIntravenous; Parenteral600 MBq/ml
SolutionIntravenous
Injection, solutionIntravenous; Parenteral
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility139.0 mg/mLALOGPS
logP-1.8ALOGPS
logP-2.7ChemAxon
logS-0.12ALOGPS
pKa (Strongest Acidic)10.32ChemAxon
pKa (Strongest Basic)-3ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count4ChemAxon
Polar Surface Area97.99 Å2ChemAxon
Rotatable Bond Count5ChemAxon
Refractivity35.65 m3·mol-1ChemAxon
Polarizability15.54 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
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

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Mannokinase activity
Specific Function
Not Available
Gene Name
HK1
Uniprot ID
P19367
Uniprot Name
Hexokinase-1
Molecular Weight
102485.1 Da

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Glucose transmembrane transporter activity
Specific Function
Insulin-regulated facilitative glucose transporter.
Gene Name
SLC2A4
Uniprot ID
P14672
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 4
Molecular Weight
54786.79 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Hexose transmembrane transporter activity
Specific Function
Facilitative glucose transporter. This isoform likely mediates the bidirectional transfer of glucose across the plasma membrane of hepatocytes and is responsible for uptake of glucose by the beta c...
Gene Name
SLC2A2
Uniprot ID
P11168
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 2
Molecular Weight
57488.955 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Xenobiotic transporter activity
Specific Function
Facilitative glucose transporter. This isoform may be responsible for constitutive or basal glucose uptake. Has a very broad substrate specificity; can transport a wide range of aldoses including b...
Gene Name
SLC2A1
Uniprot ID
P11166
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 1
Molecular Weight
54083.325 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Glucose transmembrane transporter activity
Specific Function
Facilitative glucose transporter that can also mediate the uptake of various other monosaccharides across the cell membrane (PubMed:9477959, PubMed:26176916). Mediates the uptake of glucose, 2-deox...
Gene Name
SLC2A3
Uniprot ID
P11169
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 3
Molecular Weight
53923.785 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Sugar:proton symporter activity
Specific Function
Transport urate and fructose. May have a role in the urate reabsorption by proximal tubules. Also transports glucose at low rate.
Gene Name
SLC2A9
Uniprot ID
Q9NRM0
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 9
Molecular Weight
58701.205 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Glucose transmembrane transporter activity
Specific Function
Cytochalasin B-sensitive carrier. Seems to function primarily as a fructose transporter.
Gene Name
SLC2A5
Uniprot ID
P22732
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 5
Molecular Weight
54973.42 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Glucose transmembrane transporter activity
Specific Function
Facilitative glucose transporter; binds cytochalasin B with low affinity.
Gene Name
SLC2A6
Uniprot ID
Q9UGQ3
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 6
Molecular Weight
54538.55 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Substrate-specific transmembrane transporter activity
Specific Function
High-affinity transporter for glucose and fructose Does not transport galactose, 2-deoxy-d-glucose and xylose.
Gene Name
SLC2A7
Uniprot ID
Q6PXP3
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 7
Molecular Weight
55726.915 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Glucose transmembrane transporter activity
Specific Function
Insulin-regulated facilitative glucose transporter. Binds cytochalasin B in a glucose-inhibitable manner. Seems to be a dual-specific sugar transporter as it is inhibitable by fructose (By similari...
Gene Name
SLC2A8
Uniprot ID
Q9NY64
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 8
Molecular Weight
50818.54 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Sugar:proton symporter activity
Specific Function
Facilitative glucose transporter.
Gene Name
SLC2A10
Uniprot ID
O95528
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 10
Molecular Weight
56910.77 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Substrate-specific transmembrane transporter activity
Specific Function
Facilitative glucose transporter.
Gene Name
SLC2A11
Uniprot ID
Q9BYW1
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 11
Molecular Weight
53702.055 Da
References
  1. FDA Label [Link]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Substrate-specific transmembrane transporter activity
Specific Function
Facilitative glucose transporter.
Gene Name
SLC2A12
Uniprot ID
Q8TD20
Uniprot Name
Solute carrier family 2, facilitated glucose transporter member 12
Molecular Weight
66965.7 Da
References
  1. FDA Label [Link]

Drug created on November 30, 2015 19:10 / Updated on October 07, 2021 12:09