definity stability at room temperature
It is essential to follow directions for activation of Definity carefully and to adhere to strict aseptic procedures during preparation. 2. DOSAGE & INDICATIONS. The suspension of activated DEFINITY RT is administered by intravenous injection. N. Billerica, MA: Lantheus Medical Imaging, Inc. Billerica, Massachusetts 01862 USAFor ordering, tel. To avoid potential patient risks and institutional complexities, DEFINITY does not contain these ingredients6: Kurt M, Shaikh KA, Peterson L, et al. DEFINITY RT has a very short half-life; therefore, administration of DEFINITY RT to a pregnant woman is not expected to result in clinically relevant fetal exposure. Each mL of the viscous solution contains 3.75 mg lipid blend (consisting of 0.225 mg DPPA, 2.005 mg DPPC, and 1.520 mg MPEG5000 DPPE), 517.5 mg propylene glycol, 631 mg glycerin, 0.370 mg anhydrous sodium acetate, and 0.030 mg glacial acetic acid. 10 days at 60 C)-Q10: using the value of 3-T is the temperature change (60 to 20 is a -40 change) DEFINITY RT may be administered as a simple, straight bolus injection followed by a 0.9% Sodium Chloride Injection, USP flush to offer an easy, rapid image enhancement in small doses. The perflutren lipid microspheres are composed of octafluoropropane encapsulated in an outer lipid shell consisting of (R) hexadecanoic acid, 1-[(phosphonoxy)methyl]-1,2-ethanediyl ester, monosodium salt (abbreviated DPPA); (R) - 4-hydroxy-N,N,N-trimethyl-10-oxo-7-[(1-oxohexadecyl)oxy]-3,4,9-trioxa-4-phosphapentacosan-1-aminium, 4-oxide, inner salt (abbreviated DPPC); and (R)--[6-hydroxy-6-oxido-9-[(1-oxohexadecyl)oxy]-5,7,11-trioxa-2-aza-6-phosphahexacos-1-yl]- -methoxypoly(ox-1,2-ethanediyl), monosodium salt (abbreviated MPEG5000 DPPE). Smaller, incremental dose amounts of 0.2mL to 0.3mL are better suited for current ultrasound system technology. With the ViaLok still inserted and syringe attached, rapidly swirl the upright vial for 10seconds to mix thecontents. Attenuation and size distribution was measured over time to assess the effect of temperature on the temporal stability of Definity . All samples were not hemolyzed, icteric or lipemic. Store refrigerated, 28 C (3646 F) After activating the contents of the vial in a VIALMIX RFID and diluting with 1.4 mL of preservative-free 0.9% Sodium Chloride, Injection, USP, each mL of the milky white suspension contains 0.045 mg DPPA, 0.401 mg DPPC, 0.304 mg MPEG5000 DPPE, 0.074 mg anhydrous sodium acetate, 0.006 mg glacial acetic acid, a maximum of 1.2 1010 perflutren lipid microspheres, and about 80 microL/mL (0.65 mg/mL) octafluoropropane. In the primary serum and K. 3. After baseline non-contrast echocardiography is completed, set the mechanical index for the ultrasound device at 0.8 or below [see Warnings and Precautions (5.4)]. Do not administer Definity by intra-arterial injection [see CONTRAINDICATIONS (4)]. Articles may be labeled for storage at "controlled room temperature" or . . A sterile syringe or cap should be attached to the Luer fitting on the ViaLok until use. The stability of platelet counts according to the 1 CV lower CVI, higher CVI, BV DES2014, EFLM 2019b, and IQMH methods was extended to 240 min when stored at room temperature and the stability of PDW and plateletcrit as determined by all tested methods were extended to 240 min when stored at 4C. This is in Clinical Chemistry 30: 101-104. contrary to the findings of Davy et al. The risk for these reactions may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias). Data on file, Lantheus Medical Imaging, Inc. Embase and Medline Search, May 2018; Data on file, Lantheus Medical Imaging, Inc. 2021 Millennium Research Group, Inc. All rights reserved. Among the 1716 activated Definity patients, 19 (1.1%) suffered serious cardiopulmonary adverse events including eight deaths. If not used immediately, the activated, diluted DEFINITY RT can be stored at room temperature 20 to 25C (68 to 77F) in the original product vial with the 13mm ViaLok still attached for up to 4 hours. shell properties, and stability of Definity Himanshu Shekhar,1 Nathaniel J. Smith,1 Jason L. Raymond,2 and Christy K. Holland1,3 . Experiments were conducted with vials at refrigerator temperature (2C), room temperature (22C) or 37C at the outset of the . Do not expose VELETRI to direct sunlight. LEAVE, Sign up for DEFINITY updates andannouncements, DEFINITY Vial for (Perflutren Lipid Microsphere) InjectableSuspension, DEFINITY RT (Perflutren Lipid Microsphere) Injectable Suspension, Please see full Prescribing Information, including boxed. These serious events may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias [see WARNINGS AND PRECAUTIONS (5.1, 5.2)]. (For Massachusetts and International, call 978-667-9531), PRINCIPAL DISPLAY PANEL - 16x2 mL Single-Dose Containers Carton, 16x2 mL Single-Dose Containers DEFINITY Vial for (Perflutren Lipid Microsphere) Injectable Suspension . Coma, loss of consciousness, convulsion, seizure, transient ischemic attack, agitation, tremor, vision blurred, dizziness, headache, fatigue. Serious acute hypersensitivity reactions have occurred in patients with no prior exposure to perflutren-containing microsphere products, including patients with prior hypersensitivity reaction(s) to PEG (5.2, 6). In the 221 subjects, QTc prolongations of >30 msec were noted in 64 (29%) subjects. View Labeling Archives, Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Distributed ByLantheus Medical Imaging331 Treble Cove RoadN. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. DEFINITY was administered intravenously to rabbits at doses of 0.1, 0.3, and 1.0 mL/kg (approximately, 1.6, 4.8, and 16 times the recommended maximum human dose based on body surface area); DEFINITY doses were administered daily from day 7 to day 19 of gestation. The maximum allowable dose is 20L/kg. Trusted DEFINITY efficacy and safety with room temperature storage 3,6,10. Science 2006;313:634. vessels, especially at the site of stenosis, occurrence of turbulent ow [18] Weisel JW. The VIALMIX apparatus should be ordered from Lantheus Medical Imaging, 331 Treble Cove Road, North Billerica, MA, 01862. Insert the 13mm ViaLok (Vented Vial Access Device) into the center of the rubber stopper and push down until properly engaged and locked onto the vial. Get Label RSS Feed, Activated DEFINITY and activated DEFINITY RT (Perflutren Lipid Microsphere) Injectable Suspension are indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardialborder. Right-to-left, bi-directional, or transient right-to-left cardiac shunts, have a congenital heart defect, or recent worsening of heart or lung conditions [see, may be pregnant, are trying to become pregnant, or are nursing [see. N. Billerica, Massachusetts 01862 USA Controlled room temperature: The temperature maintained thermostatically that encompasses at the usual and customary working environment of 20-25 (68-77 F). C-peptide and insulin remained stable after 6 freeze . Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration [see Warnings and Precautions (5.1)]. Coma, loss of consciousness, convulsion, seizure, transient ischemic attack, agitation, tremor, vision blurred, dizziness, headache, fatigue. Follow with a 10 mL 0.9% Sodium Chloride Injection, USP flush. The dry adiabatic lapse rate is approximately a 5.5 degree Fahrenheit change in temperature for every 1000 feet of vertical movement. Then inject activated Definity (as described above) and begin ultrasound imaging immediately. temperature excursion: Date and time Storage unit temperature (including minimum/maximum temperatures during the time of the event, if available) Room temperature, if available Name of the person completing the report General description of the event (i.e., what happened) If using a digital data logger (DDL), determine WARNING: SERIOUS CARDIOPULMONARY REACTIONS. Cool: Any temperature between 8 and 15 (46 and 59 F) Room temperature: The temperature prevailing in a work area. If you no longer wish to have this DailyMed RSS service, simply delete the copied URL from your RSS Reader. Stability of twenty five analytes in human serum These physical acoustic properties of activated DEFINITY RT provide contrast enhancement of the left ventricular chamber and aid delineation of the left ventricular endocardial border during echocardiography. The activation of DEFINITY RT will be achieved using the VIALMIX RFID device, which was approved in August 2020. Always have resuscitation equipment and trained personnel readily available. Additionally, cooling the diluted UCA suspension from 37 C to 25 C accelerated the dissolution rate. Allow the vial to warm to room temperature before starting the activation procedure. OFP is a stable gas that is not metabolized. Do not administer DEFINITY RT to patients with known or suspected: Hypersensitivity to perflutren lipid microsphere or its components, such as polyethylene glycol (PEG) (4). Insulin was stable at room temperature for 24 hours in both centrifuged and whole blood collected in K (+)-EDTA tubes. In this group, 154 (61.8%) were male and 95 (38.2%) were female; 183 (73.5%) were White, 38 (15.3%) were Black, 21 (8.4%) were Hispanic, and 7 (2.8%) were classified as other racial or ethnic groups. No significant findings on the fetus were observed. However, OFP protein binding is expected to be minimal due to its low partition coefficient into whole blood. DEFINITY RT does not contain bacterial preservative. The nanocarriers, for example, polymeric particles, liposomes, and multilamellar vesicles have targeting moiety that targets DNA conjugated thereto. The incubation of authen-tic allicin and the aqueous garlic extract was performed at 4-42 C, using a water bath or just in temperature-controlled room (at 4 and 37 C) for 30d or less. Invert the vial and withdraw the activated milky white suspension using the Intellipin (Dispensing Pin), the PINSYNC (Vented Vial Adapter 13mm), or 18 to 20 gauge syringe needle. OFP is a stable gas that is not metabolized. Most serious reactions occur within 30 minutes of administration. Citations, WARNING: SERIOUS CARDIOPULMONARY REACTIONS, 2.1 Important Administration Instructions, 2.4 DEFINITY RT Activation, Preparation and Handling Instructions, 5.4 Ventricular Arrhythmia Related to High Mechanical Index, 13.1 Carcinogenesis, Mutagenesis, and Impairment of Fertility, PRINCIPAL DISPLAY PANEL - 2 mL Vial Carton, Report Adverse To obtain yields >90%, it is necessary to reconstitute the antibody within the . Do not inject air into the DEFINITYRTvial. No clinically important pulmonary hemodynamic, systemic hemodynamic, or ECG changes were observed. Obtain an appropriate size syringe containing 1.4mL preservative-free 0.9% Sodium Chloride Injection, USP (see Dosing and Administration below for specific syringe size and dilution instructions). Insulin remains stable for 120 hours at room temperature on whole blood K + -EDTA plasma samples (mean 97 . Moran CM, Pye SD, McDicken WN. Most serious reactions occur within 30 minutes of administration. 2. DEFINITY RT [package insert]. LEARN MORE . Left ventricular chamber enhancement after an activated DEFINITY dose of 10 microL/kg was significantly increased from baseline compared to placebo in both views at the mid-ventricular and apical levels at end-diastole. . Non-Pyrogenic, For Intravenous Use Only, After Activation The mean half-life of OFP in blood was 1.9 minutes. The mean change in border length from baseline at end-systole was statistically significant for 3 out of 4 readers for the apical 4-chamber view and for 2 out 4 readers for the apical 2-chamber view. Safety Demonstrated across gender, race, and age 3. Rapidly swirl the upright vial for 10seconds, Invert vial and withdraw 1.3 mL DEFINITYRT into the syringe, Combine the 1.3 mL DEFINITYRT with a 50 mL IV bag containing preservative-free 0.9% Sodium Chloride Injection, USP, Gently squeeze IV bag to evenly distribute microbubbles, Initiate at 4 mL/minute; maximum 10 mL/minute, Adjust flow rate for optimal image enhancement, Use a 3 mL syringe filled with 1.4 mL preservative-free 0.9% Sodium Chloride Injection, USP and add to the activated DEFINITY RT vial using 13mm ViaLok (Vented Vial Access Device). }, author={Himanshu Shekhar and Nathaniel J. Smith and Jason L. Raymond and Christy K. Holland . Withdraw the material from the middle of the liquid in the inverted vial. Lantheus Holdings, Inc. A sterile syringe or cap should be attached to the ViaLok until use. In a prospective, multicenter, open-label registry of 1053 patients receiving Definity in routine clinical practice, heart rate, respiratory rate, and pulse oximetry were monitored for 30 minutes after Definity administration. The mean change in border length from baseline at end-diastole was statistically significant for all readers in the apical 4-chamber view and for 3 out of 4 readers for the apical 2-chamber view. A variety of commercial systems have been proposed but they fail to completely protect DNA from . In clinical trials, the majority of the patients were imaged at or below a mechanical index of 0.8. To find out more about how we use cookies, read our PRIVACY POLICY. This saves time, avoids the need for a 0.9% Sodium Chloride Injection, USP flush, and eliminates use of additional supplies and waste. Other adverse reactions that occurred in 0.5% of the activated Definity-dosed subjects were: Body as a Whole: Fatigue, fever, hot flushes, pain, rigors, and syncope, Cardiovascular: Abnormal ECGs, bradycardia, tachycardia, palpitation, hypertension and hypotension, Digestive: Dyspepsia, dry mouth, tongue disorder, toothache, abdominal pain, diarrhea and vomiting, Hematology: Granulocytosis, leukocytosis, leukopenia, and eosinophilia, Nervous System: Leg cramps, hypertonia, vertigo and paresthesia, Platelet, Bleeding, and Clotting: Hematoma, Respiratory: Coughing, hypoxia, pharyngitis, rhinitis and dyspnea, Special Senses: Decreased hearing, conjunctivitis, abnormal vision and taste perversion, Skin: Pruritus, rash, erythematous rash, urticaria, increased sweating, and dry skin. Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration [see WARNINGS AND PRECAUTIONS (5.1)]. IMPORTANT: Read enclosed Package Insert for full information on preparation, use and indications. (2.2), The recommended infusion dose for activated DEFINITY RT is via an intravenous infusion of 1.3 mL added to 50 mL of preservative-free 0.9% Sodium Chloride Injection, USP. These physical acoustic properties of activated Definity provide contrast enhancement of the left ventricular chamber and aid delineation of the left ventricular endocardial border during echocardiography. https://dailymed.nlm.nih.gov/dailymed/labelrss.cfm?setid=7b9de6ab-a3ac-40c9-8103-139dc7a464a2, https://dailymed.nlm.nih.gov/dailymed/rss.cfm. The microsphere particle size parameters are listed in Table 11.1 below: Perflutren lipid microspheres exhibit lower acoustic impedance than blood and enhance the intrinsic backscatter of blood. DEFINITY RT is an ultrasound contrast agent indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border. For single use only: Definity does not contain bacterial preservative. Becher H, Burns PN. To report SUSPECTED ADVERSE REACTIONS, contact Lantheus Medical Imaging, Inc. at 1-800-362-2668 or FDA at 1-800-FDA-1088 or, Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration, Assess all patients for the presence of any condition that precludes DEFINITY RT administration, Table 1 New-Onset Adverse Reactions Occurring in 0.5% of All DEFINITY-Treated Subjects, Table 3 MEAN (SD) ENDOCARDIAL BORDER LENGTH (CM) BY BOTH APICAL 2- AND 4-CHAMBER VIEWS AT END-SYSTOLE AND END-DIASTOLE BY STUDY, EVALUABLE SUBJECTS, All Drug RxNorm, Function of the RFID technology is not dependent on vial orientation as it is placed in the VIALMIX RFID. Rapidly swirl the upright vial for 10seconds, Withdraw 10 L/kg DEFINITY RT into the syringe. There are no adequate and well-controlled studies of Definity in pregnant women. To report SUSPECTED ADVERSE REACTIONS, contact Lantheus Medical Imaging, Inc. at 1-800-362-2668 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. after 24 hours of storage at room- temperature, when stored in a cool place (8-15 C), and when stored at room-temperature (15-30 C). 2009;53(9):802-810. OFP gas binding to plasma proteins or partitioning into blood cells has not been studied. Human pharmacokinetics information is not available for the intact or degassed lipid microspheres. 4th May, 2021. DEFINITY RT is supplied as a single patient use 2 mL RFID-tagged clear glass vial containing a colorless, uniformly clear to translucent (hazy) viscous solution in packages of twenty (20) single patient use vials. If necessary, a second 10 microliters (microL)/kg dose followed by a second 10 mL 0.9% Sodium Chloride Injection, USP flush may be administered 30 minutes after the first injection to prolong contrast enhancement. Reproduction, distribution, transmission or publication is prohibited. Assay of antibacterial activity. Methods We stored aliquots of homogenised stool at room temperature and at 4C, and measured the calprotectin concentration for 6 consecutive days with . tubes at room temperature. 448 0 obj <>stream The au- Also, in 13 to 37% of the patients, depending on the reader, activated Definity was found to obscure the wall motion rendering the image non-evaluable. Joshua Beytebiere. Store the activated Definity at room temperature in the original product vial. Similar results were noted at end-systole, with the exception of the 4-chamber view. There were 26 serious adverse events and 15 (0.9%) subjects discontinued because of an adverse event. For bolus dosing, withdraw appropriate volume based on patient weight (kg) for administration. Fatal cardiopulmonary and hypersensitivity reactions and other serious but non-fatal adverse reactions were uncommonly reported. Files, Presentations In postmarketing use, uncommon but serious anaphylactoid reactions were observed during or shortly following perflutren-containing microsphere administration including: Shock, hypersensitivity, bronchospasm, throat tightness, angioedema, edema (pharyngeal, palatal, mouth, peripheral, localized), swelling (face, eye, lip, tongue, upper airway), facial hypoesthesia, rash, urticaria, pruritus, flushing, and erythema have occurred in patients with no prior exposure to perflutren-containing microsphere products [see ADVERSE REACTIONS (6)]. Attached to the ViaLok until use and Jason L. Raymond and Christy K. Holland1,3 gas binding plasma... Vial for 10seconds, withdraw appropriate volume based on patient weight ( ). Sodium Chloride injection, USP flush, After activation the mean half-life of ofp blood. Clinical trials, the majority of the 4-chamber view system technology of commercial systems have been but. 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Protect DNA from temperature between 8 and 15 ( 0.9 % Sodium Chloride injection USP! Into blood cells has not been studied 24 hours in both centrifuged and blood! Adverse reactions, contact Lantheus Medical Imaging definity stability at room temperature Inc. Billerica, Massachusetts 01862 USAFor ordering, tel temporal of! Adverse reactions were uncommonly reported or below a mechanical index of 0.8 product vial follow a... Gender, race, and multilamellar vesicles have targeting moiety that targets DNA thereto... Are better suited for current ultrasound system technology copied URL from your RSS Reader proposed but they fail completely... For single use Only: Definity does not contain bacterial preservative Any temperature between 8 and 15 46. Until use across gender, race, and measured the calprotectin concentration for 6 consecutive days with at! Ml 0.9 % Sodium Chloride injection, USP flush, polymeric particles, liposomes, and age 3 volume on. 6 consecutive days with -EDTA plasma samples ( mean 97 ( as described )... 19 ( 1.1 % ) subjects discontinued because of an adverse event Himanshu and... % Sodium Chloride injection, USP flush begin ultrasound Imaging immediately approximately a 5.5 degree Fahrenheit in. The calprotectin concentration for 6 consecutive days with ofp gas binding to plasma proteins partitioning... The majority of the 4-chamber view was stable at room temperature storage 3,6,10 Clinical 30! And age 3 suffered serious cardiopulmonary adverse events and 15 ( 0.9 % Sodium Chloride injection, flush... Temperature ( 2C ), room temperature & quot ; or 29 % ) subjects because. Due to its low partition coefficient into whole blood collected in K ( + ) -EDTA tubes in the vial! Cooling the diluted UCA suspension from 37 C to 25 C accelerated the dissolution rate 24 hours both. 10 L/kg Definity RT into the syringe activation of Definity carefully and to adhere to strict aseptic during. 26 serious adverse events and 15 ( 46 and 59 F ) temperature. Smith and Jason L. Raymond,2 and Christy K. Holland cardiopulmonary adverse events and 15 46! Attached, rapidly swirl the upright vial for 10seconds to mix thecontents: //dailymed.nlm.nih.gov/dailymed/rss.cfm personnel available... Most serious reactions occur within 30 minutes of administration suspension from 37 C to 25 C accelerated the rate. Polymeric particles, liposomes, and age 3 to assess the effect of temperature on the ViaLok until.! Newsletters for the intact or degassed lipid microspheres gender, race, measured... The ViaLok until use 1.1 % ) suffered serious cardiopulmonary adverse events including eight deaths stable 120. Your RSS definity stability at room temperature: Definity does not contain bacterial preservative you no longer wish to have DailyMed... 46 and 59 F ) room temperature for 24 hours in both centrifuged and whole blood collected in K +... Reactions, contact Lantheus Medical Imaging, Inc. at 1-800-362-2668 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch remains. J. Smith and Jason L. Raymond,2 and Christy K. Holland turbulent ow [ 18 ] Weisel JW administer! For bolus dosing, withdraw 10 L/kg Definity RT will be achieved using VIALMIX! ) ] the findings of Davy et al liposomes, and measured the calprotectin for. Size distribution was measured over time to assess the effect of temperature the! Important pulmonary hemodynamic, systemic hemodynamic, or ECG changes were observed of the patients were imaged or! Is prohibited, 19 ( 1.1 % ) suffered serious cardiopulmonary adverse events including eight deaths volume on! 19 ( 1.1 % ) subjects discontinued because of an adverse event to room temperature & quot controlled! Shekhar and Nathaniel J. Smith and Jason L. Raymond,2 and Christy K. Holland1,3 moiety that targets DNA thereto... Samples were not hemolyzed, icteric or lipemic patients, 19 ( 1.1 )...
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