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Lutathera

Generic name: lutetium Lu 177 dotatate
Drug class: Therapeutic radiopharmaceuticals

Medically reviewed by  A Ras MD.

What is Lutathera used for?

Lutathera is a prescription medicine that is used to treat a certain type of cancer called neuroendocrine tumor from the gastrointestinal tract or the pancreas (GEP-NETs).

Description

Lutetium Lu 177 dotatate is a radiolabeled somatostatin analog. The drug substance lutetium Lu 177 dotatate is a cyclic peptide linked with the covalently bound chelator 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid to a radionuclide.

Lutetium Lu 177 dotatate is described as lutetium (Lu 177)-N-[(4,7,10-Tricarboxymethyl-1,4,7,10-tetraazacyclododec-1-yl) acetyl]-D-phenylalanyl-L-cysteinyl-L-tyrosyl-D-tryptophanyl-L-lysyl-L-threoninyl-L-cysteinyl-L-threonine-cyclic (2-7) disulfide. The molecular weight is 1609.6 Daltons and the structural formula is as follows:

Lutetium Lu 177 dotatate structural formula

LUTATHERA (lutetium Lu 177 dotatate) 370 MBq/mL (10 mCi/mL) Injection is a sterile, clear, colorless to slightly yellow solution for intravenous use. Each single-dose vial contains acetic acid (0.48 mg/mL), ascorbic acid (2.8 mg/mL), diethylene triamine pentaacetic acid (0.05 mg/mL), gentisic acid (0.63 mg/mL), sodium acetate (0.66 mg/mL), sodium chloride (6.85 mg/mL), sodium hydroxide (0.65 mg/mL), and Water for Injection (ad 1 mL). The pH range of the solution is 4.5 to 6.

 Mechanism of Action

Lutetium Lu 177 dotatate binds to somatostatin receptors with highest affinity for subtype 2 receptors (SSRT2). Upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumors, the compound is internalized. The beta emission from Lu 177 induces cellular damage by formation of free radicals in somatostatin receptor-positive cells and in neighboring cells.

Before taking Lutathera, tell your doctor:

  • If you are allergic to Lutathera; any part of this medicine; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you are taking or will be taking another drug like this one.
  • If you are breast-feeding. Do not breast-feed for at least 10 weeks after your last dose.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Lutathera with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Lutathera?

  • Tell all of your health care providers that you take Lutathera. This includes your doctors, nurses, pharmacists, and dentists.
  • This medicine is radioactive. You will need to follow what the doctor has told you to lessen being exposed to Lutathera.
  • Pass urine often. You need to empty your bladder often. Drinking lots of liquids will help.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
  • Rarely, a bone marrow problem called myelodysplastic syndrome (MDS) has happened in patients treated with Lutathera. A type of leukemia has also rarely happened. If you have questions, talk with the doctor.
  • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
  • Tell your doctor if you have signs of high or low blood sugar like breath that smells like fruit, dizziness, fast breathing, fast heartbeat, feeling confused, feeling sleepy, feeling weak, flushing, headache, more thirsty or hungry, passing urine more often, shaking, or sweating.
  • This medicine may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child.
  • If you are a man and have sex with a female who could get pregnant, protect her from pregnancy during treatment and for at least 4 months after your last dose.
  • If you are a man and your sex partner gets pregnant while you take Lutathera or within 4 months after your last dose, call your doctor right away.
  • This medicine may cause harm to the unborn baby if you take it while you are pregnant.
  • If you are able to get pregnant, a pregnancy test will be done to show that you are NOT pregnant before starting Lutathera. Talk with your doctor.
  • Use birth control that you can trust to prevent pregnancy while taking Lutathera and for at least 7 months after stopping Lutathera.
  • If you get pregnant while taking Lutathera or within 7 months after your last dose, call your doctor right away.

How is Lutathera best taken?

Use Lutathera as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • It is given as an infusion into a vein over a period of time.
  • Other drugs may be given with Lutathera to help avoid side effects.

What do I do if I miss a dose?

  • Call your doctor to find out what to do.

What are the side effects of Lutathera that I need to call my doctor about immediately?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Signs of electrolyte problems like mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, seizures, not hungry, or very bad upset stomach or throwing up.
  • Feeling very tired or weak.
  • Flushing.
  • Severe diarrhea.
  • A heartbeat that does not feel normal.
  • Swelling in the arms or legs.

What are some other side effects of Lutathera?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Upset stomach or throwing up.
  • Belly pain.
  • Diarrhea.
  • Constipation.
  • Feeling tired or weak.
  • Not hungry.
  • Back pain.
  • Pain in arms or legs.
  • Muscle pain.
  • Neck pain.
  • Headache.
  • Dizziness.
  • Change in taste.
  • Anxiety.
  • Hair loss.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If overdose is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Lutathera?

  • If you need to store Lutathera at home, talk with your doctor, nurse, or pharmacist about how to store it.

 

Label

PRINCIPAL DISPLAY PANEL

Type A Label (ADR)

Lutetium Lu 177 dotatate injection
Activity at calibration time:
370 MBq/mL (10 mCi/mL)
Rx Only
NDC# 69488-003-70

PRINCIPAL DISPLAY PANEL Type A Label (ADR) Lutetium Lu 177 dotatate injection Activity at calibration time: 370 MBq/mL (10 mCi/mL) Rx Only NDC# 69488-003-70

PRINCIPAL DISPLAY PANEL

Type A Label (IATA)

Lutetium Lu 177 dotatate injection
Activity at calibration time:
370 MBq/mL (10 mCi/mL)
Rx Only
NDC# 69488-003-70

PRINCIPAL DISPLAY PANEL Type A Label (IATA) Lutetium Lu 177 dotatate injection Activity at calibration time: 370 MBq/mL (10 mCi/mL) Rx Only NDC# 69488-003-70

SRC: NLM .

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