Drug General Information (ID: DDIN2W18LB)
Drug Name			Iobenguane (I-131)		Drug Info		Methylene blue		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Therapeutic Radiopharmaceuticals				Antidotes/Mao Inhibitors
Structure

Mechanism of Iobenguane (I-131)-Methylene blue Interaction (Severity Level: Major)
Interference of cell/tissue uptake Click to Show/Hide Mechanism Graph
Drug Name		Iobenguane (I-131)				Methylene blue
Mechanism		Radiolabeled norepinephrine analog				Interference with hepatic synthesis of vitamin K-dependent coagulation factors
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the distribution of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Interference of cell/tissue uptake of Iobenguane (I-131) by Methylene blue

Recommended Action
Management		Drugs that reduce catecholamine uptake or deplete catecholamine stores should be discontinued for at least five biological half-lives before administration of either the dosimetry dose or a therapeutic dose of iobenguane I-131. Do not administer these drugs until at least 7 days after each iobenguane I-131 dose. Patients should be monitored for the occurrence of clinically significant withdrawal symptoms, especially patients with elevated levels of circulating catecholamines and their metabolites.

References
1	Product Information. Azedra (iobenguane I-131). Progenics Pharmaceuticals, Inc., New York, NY.