Sodium Fluoride Injection
FDA Label NDC 76451-018

Full FDA labeling including Indications, Dosage, Usage, and Precautions

Structured Product Label

The following Structured Product Label (SPL) was submitted to the FDA by 3d Imaging Drug Design And Development Llc for the product Sodium Fluoride (NDC 76451-018). This document serves as the official prescribing information, containing essential scientific data and clinical materials required for healthcare providers and patients.

This specific version of the label includes detailed information regarding 3 dosage forms and strengths, 6 adverse reactions, 11 description, 11.1 chemical characteristics, 11.2 physical characteristics, 16 how supplied, storage, handling, and other regulatory disclosures. Use the navigation below to review specific sections of the FDA submission.

3 Dosage Forms And Strengths

Multiple-dose vial or single-dose syringe containing 370–7,400 MBq/mL (10–200 mCi/mL) at EOS reference time of no-carrier-added sodium fluoride F18 in aqueous 0.9% sodium chloride solution. Sodium Fluoride F 18 Injection is a clear, colorless, sterile, pyrogen-free and preservative-free solution for intravenous administration.

6 Adverse Reactions

No adverse reactions have been reported for Sodium Fluoride F 18 Injection based on a review of the published literature, publicly available reference sources, and adverse drug reaction reporting systems. However, the completeness of these sources is not known.

11 Description

11.1 Chemical Characteristics

Sodium Fluoride F 18 Injection is a positron emitting radiopharmaceutical, containing no-carrier-added, radioactive fluoride F18 that is used for diagnostic purposes in conjunction with PET imaging. It is administered by intravenous injection. The active ingredient, sodium fluoride F18, has the molecular formula Na[18F] with a molecular weight of 40.99, and has the following chemical structure:  Na+ F-

Sodium Fluoride F 18 Injection is provided as a ready-to-use, isotonic, sterile, pyrogen-free, preservative-free, clear and colorless solution. Each mL of the solution contains between 370 MBq to 7,400 MBq (10 mCi to 200 mCi) sodium fluoride F18, at the EOS reference time, in 0.9% aqueous sodium chloride. The pH of the solution is between 4.5 and 8. The solution is presented in 10 mL multiple- dose glass vials or 5 mL or 10 mL plastic syringes with variable total volume and total radioactivity in each vial.

11.2 Physical Characteristics

Fluoride F18 decays by positron (+) emission and has a half-life of 109.7 minutes. Ninety-seven percent of the decay results in emission of a positron with a maximum energy of 633 keV and 3% of the decay results in electron capture with subsequent emission of characteristic X-rays of oxygen. The principal photons useful for diagnostic imaging are the 511 keV gamma photons, resulting from the interaction of the emitted positron with an electron (Table 2). Fluorine F18 atom decays to stable 18O-oxygen.

Table 2: Principal Emission Data for Fluoride F18
Radiation/Emission% per DisintegrationMean Energy
Positron (+)96.73249.8 keV
Gamma (±) 193.46511.0 keV

The specific gamma ray constant (point source air kerma coefficient) for fluoride F18 is 5.7 R/hr/mCi (1.35 x 10 -6 Gy/hr/kBq) at 1 cm. The half-value layer (HVL) for the 511 keV photons is 4 mm lead (Pb). A range of values for the attenuation of radiation results from the interposition of various thickness of Pb. The range of attenuation coefficients for this radionuclide is shown in Table 3. For example, the interposition of an 8 mm thickness of Pb with a coefficient of attenuation of 0.25 will decrease the external radiation by 75%.

Table 3:Radiation Attenuation of 511 keV Photons by Lead (Pb) Shielding
Shield Thickness (Pb) mmCoefficient of Attenuation
00.00
40.50
80.25
130.10
260.01
390.001
520.0001

Table 4 lists the fraction of radioactivity remaining at selected time intervals from the calibration time. This information may be used to correct for physical decay of the radionuclide.

Table 4: Physical Decay Chart for Fluoride F18
Time Since CalibrationFraction Remaining
01.00
15 minutes0.909
30 minutes0.826
60 minutes0.683
110 minutes0.500
220 minutes0.250
440 minutes0.060
12 hours0.011
24 hours0.0001

16 How Supplied

Sodium Fluoride F 18 Injection is supplied in a multiple-dose Type I glass vial with (elastomeric) stopper and aluminum crimp seal, or plastic syringe with cap, containing between 370 and 7,400 MBq/mL (10–200 mCi/mL) of no carrier-added sodium fluoride F18, at the EOS reference time, in aqueous 0.9% sodium chloride solution. The total volume and total radioactivity per vial or syringe are variable. Each vial or syringe is enclosed in a shielded container of appropriate thickness.

The product is availablein a 10 mL vial or a 5 or 10 mL plastic syringe configuration with a variable fill volume. The NDC numbers are:
76451-018-10 (10 mL vial)
76451-018-11 (10 mL syringe)
76451-018-51 ( 5 mL syringe)

Storage

Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F). Use the solution within 12 hours of the EOS reference time.

Handling

Receipt, transfer, handling, possession, or use of this product is subject to the radioactive material regulations and licensing requirements of the U.S. Nuclear Regulatory Commission, Agreement States or Licensing States as appropriate.

Other

Manufactured by: 3D Imaging Drug Design and Development LLC, 9015 Carti Way, Little Rock, AR 72205

Distributed by:  3D Imaging Drug Design and Development LLC, 9015 Carti Way, Little Rock, AR 72205

Package Inner And Outer Labels

Outer labels are exterior to the radiation shielding for the product vial and contain the direct labeling information. There is an inner label that can be printed and applied in advance to avoid radiation dose to the operators and is small enough to affix to the vial. The inner label contains the product name and a batch number that positively connects it to the correct outer label. The outer label contains complete package label information and all dose information that is determined at the time of filling.

10 Ml Vial Outer Label

10 mL Vial Outer

10 mL Vial Outer Label (Vial10fluoride)

10 mL Vial Outer Label (Vial10fluoride)

10 Ml Syringe Outer Label

10 mL Syringe Outer 

10 mL Syringe Outer Label (Syringe10fluoride)

10 mL Syringe Outer Label (Syringe10fluoride)

5 Ml Syringe Outer Label

5 mL Syringe Outer 

5 mL Syringe Outer Label (Syringe5fluoride)

5 mL Syringe Outer Label (Syringe5fluoride)

Inner Label, All

Inner

Inner Label, All (Innerall)

Inner Label, All (Innerall)

, All

* Please review the disclaimer below.