Tetrofosmin

Identification

Summary

Tetrofosmin is a diphosphine complexed with technetium 99 used for imaging to determine myocardial ischemia, infarcted myocardium, and assessment of left ventricular function.

Generic Name
Tetrofosmin
DrugBank Accession Number
DB11180
Background

Tetrofosmin was developed to overcome the non-target uptake of radioligands by the generation of hetero-atomic compounds. It presents a molecular formula of 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane. Tetrofosmin is part of the group of diphosphines. Tetrofosmin is used in conjunction with technetium Tc-99m as a radiopharmaceutical.1

Type
Small Molecule
Groups
Approved
Structure
Weight
Average: 382.462
Monoisotopic: 382.240183764
Chemical Formula
C18H40O4P2
Synonyms
  • Tetrofosmin
  • Tetrofosmina
External IDs
  • P-53
  • P53

Pharmacology

Indication

Tetrofosmin is indicated to be used as a complex with technetium Tc-99m for scintigraphic imaging of the myocardium following separate administrations under exercise and/or resting conditions. It helps in the delineation of regions of reversible myocardial ischemia in absence of infarcted myocardium.4

This complex is also used for scintigraphic imaging of the myocardium to identify changes in perfusion induced by pharmacologic stress in patients with known or suspected coronary artery disease.4

This complex is indicated for the assessment of left ventricular function in patients evaluated for heart disease.4

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Used in combination as diagnostic agentBreast cancerCombination Product in combination with: Sodium bicarbonate (DB01390)•••••••••••••••••••••• ••••••• ••• ••••••••
Used in combination as diagnostic agentBreast cancerCombination Product in combination with: Sodium bicarbonate (DB01390)•••••••••••••••••••••• ••••••• ••• ••••••••
Used in combination as diagnostic agentHypoperfusionCombination Product in combination with: Sodium bicarbonate (DB01390)•••••••••••••••••••••• ••••••• ••• ••••••••
Used in combination as diagnostic agentMyocardial infarctionCombination Product in combination with: Sodium bicarbonate (DB01390)•••••••••••••••••••••• ••••••• ••• ••••••••
Contraindications & Blackbox Warnings
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Pharmacodynamics

Refer to Technetium Tc-99m tetrofosmin

Mechanism of action

Tetrofosmin normal biodistribution makes it suitable to be used as a myocardial agent as it is uptaken by the myocardial tissue and it presents a very low redistribution after 3-4 hours of administration.2 After distribution, tetrofosmin is a lipophilic cationic agent which is passively diffused and accumulated in viable myocardial tissue.3

Absorption

After intravenous administration, tetrofosmin is rapidly cleared from the blood and taken up by the heart, skeletal muscle, liver, spleen and kidneys.2

Volume of distribution

This pharmacokinetic property has not been fully studied.

Protein binding

Refer to Technetium Tc-99m tetrofosmin

Metabolism

This pharmacokinetic property has not been fully studied.

Route of elimination

Refer to Technetium Tc-99m tetrofosmin

Half-life

Refer to Technetium Tc-99m tetrofosmin

Clearance

Refer to Technetium Tc-99m tetrofosmin

Adverse Effects
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Toxicity

The toxicity of tetrofosmin as an individual agent has not been studied.

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.
Not Available
Food Interactions
  • Take with food. Some studies have found that this improves imaging.

Products

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dosage, form, labeller, route of administration, and marketing period.
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
MyoviewInjection, powder, lyophilized, for solution1.38 mg/1IntravenousMedi-Physics Inc. dba GE Healthcare2009-02-26Not applicableUS flag
MyoviewInjection, powder, lyophilized, for solution0.23 mg/1IntravenousMedi-Physics Inc. dba GE Healthcare1996-02-09Not applicableUS flag
TetrofosminInjection, powder, lyophilized, for solution0.35 mg/1IntravenousAnazao Health Corporation2012-05-23Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Tetrofosmin ROTOP 0,23 mg Kit für ein radioaktives ArzneimittelTetrofosmin (0.23 mg) + Sodium bicarbonate (2.5 ml)Injection, powder, for solutionIntravenousRotop Pharmaka Gmb H2018-04-30Not applicableAustria flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
TetrofosminTetrofosmin (0.35 mg/1)Injection, powder, lyophilized, for solutionIntravenousAnazao Health Corporation2012-05-23Not applicableUS flag

Categories

Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as organic phosphines and derivatives. These are organic compounds containing a phosphine derivative, with the general formula B1P(R2)R3 (R1-R3=alkyl, aryl).
Kingdom
Organic compounds
Super Class
Organophosphorus compounds
Class
Organic phosphines and derivatives
Sub Class
Not Available
Direct Parent
Organic phosphines and derivatives
Alternative Parents
Dialkyl ethers / Organopnictogen compounds / Hydrocarbon derivatives
Substituents
Aliphatic acyclic compound / Dialkyl ether / Ether / Hydrocarbon derivative / Organic oxygen compound / Organooxygen compound / Organopnictogen compound / Phosphine
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
3J0KPB596Q
CAS number
127502-06-1
InChI Key
QCWJONLQSHEGEJ-UHFFFAOYSA-N
InChI
InChI=1S/C18H40O4P2/c1-5-19-9-13-23(14-10-20-6-2)17-18-24(15-11-21-7-3)16-12-22-8-4/h5-18H2,1-4H3
IUPAC Name
6,9-bis(2-ethoxyethyl)-3,12-dioxa-6,9-diphosphatetradecane
SMILES
CCOCCP(CCOCC)CCP(CCOCC)CCOCC

References

General References
  1. Kelly JD, Forster AM, Higley B, Archer CM, Booker FS, Canning LR, Chiu KW, Edwards B, Gill HK, McPartlin M, et al.: Technetium-99m-tetrofosmin as a new radiopharmaceutical for myocardial perfusion imaging. J Nucl Med. 1993 Feb;34(2):222-7. [Article]
  2. Jain D, Wackers FJ, Mattera J, McMahon M, Sinusas AJ, Zaret BL: Biokinetics of technetium-99m-tetrofosmin: myocardial perfusion imaging agent: implications for a one-day imaging protocol. J Nucl Med. 1993 Aug;34(8):1254-9. [Article]
  3. Jadvar H. (2014). Cancer theranostics. Academic press.
  4. Tetrofosmin monograph [Link]
  5. FDA Approved Drug Products: Myoview (Kit for the preparation of technetium Tc99m tetrofosmin injection) for intravenous injection [Link]
PubChem Compound
4274
PubChem Substance
347827934
ChemSpider
4124
RxNav
1311569
ChEBI
135598
ChEMBL
CHEMBL1615784
ZINC
ZINC000003780929
Wikipedia
Technetium_(99mTc)_tetrofosmin
FDA label
Download (222 KB)
MSDS
Download (284 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedDiagnosticCoronary Artery Disease (CAD)1
3CompletedDiagnosticCoronary Artery Disease (CAD)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, powder, for solutionIntravenous
Injection, powder, for solutionIntravenous; Parenteral0.23 mg
Injection, powder, lyophilized, for solutionIntravenous0.23 mg/1
Injection, powder, lyophilized, for solutionIntravenous1.38 mg/1
Injection, powder, for solutionIntravenous0.23 mg
Injection, powder, lyophilized, for solutionIntravenous230 mcg
Injection, powder, lyophilized, for solutionIntravenous0.35 mg/1
Injection, powder, for solutionIntravenous
Kit; powder, for solutionIntravenous
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US9549999No2017-01-242030-03-10US flag

Properties

State
Liquid
Experimental Properties
PropertyValueSource
boiling point (°C)100ºC'MSDS'
water solubilitySoluble 'MSDS'
Predicted Properties
PropertyValueSource
Water Solubility0.000664 mg/mLALOGPS
logP3.85ALOGPS
logP1.14Chemaxon
logS-5.8ALOGPS
pKa (Strongest Basic)8.3Chemaxon
Physiological Charge2Chemaxon
Hydrogen Acceptor Count4Chemaxon
Hydrogen Donor Count0Chemaxon
Polar Surface Area36.92 Å2Chemaxon
Rotatable Bond Count19Chemaxon
Refractivity115.73 m3·mol-1Chemaxon
Polarizability45.62 Å3Chemaxon
Number of Rings0Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
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-MSsplash10-056r-9347000000-2c38e9d9ea15fdd91702
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-001i-0009000000-79973081273650b0a73b
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-001i-0009000000-67e2db15753bff783fcc
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-0019-0039000000-f7cd2286cdc58acaa527
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-0pj0-0019000000-67a053a2259a2210e2cf
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-00mo-0591000000-7612d0322a2d7f586a98
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-000i-0189000000-e21d5422347d47e39d88
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-178.99753
predicted
DeepCCS 1.0 (2019)
[M+H]+181.35553
predicted
DeepCCS 1.0 (2019)
[M+Na]+187.80101
predicted
DeepCCS 1.0 (2019)

Drug created at December 03, 2015 16:51 / Updated at February 21, 2021 18:53