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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Yttrium Iodide
Generic Name
Yttrium Iodide
Active Ingredient
YttriumCategory
Calcium [EPC]
Variants
8
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 6 [hp_C]/1 | PELLET | ORAL | 37662-3156 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-3157 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-3160 |
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Yttrium Iodide, you must consult a qualified healthcare professional.
| 1 [hp_M]/1 | PELLET | ORAL | 37662-3162 |
| 1 [hp_Q]/1 | PELLET | ORAL | 37662-3163 |
| 30 [hp_C]/1 | PELLET | ORAL | 37662-3158 |
| 500 [hp_C]/1 | PELLET | ORAL | 37662-3161 |
| 100 [hp_C]/1 | PELLET | ORAL | 37662-3159 |
Detailed information about Yttrium Iodide
Yttrium is a rare earth element primarily utilized in medicine as the radioactive isotope Yttrium-90 (Y-90). It belongs to classes including Calcium [EPC] and Standardized Chemical Allergens, and is most notably used in radioembolization and radioimmunotherapy for cancer treatment.
Dosage for Yttrium-90 is not calculated in milligrams, but in Gigabecquerels (GBq) or Millicuries (mCi), which measure radioactive activity.
Yttrium-90 is not routinely approved for pediatric use. However, in specialized oncology centers, it may be used off-label for pediatric liver tumors (hepatoblastoma). Dosing in these cases is strictly determined by pediatric interventional radiologists based on tumor volume and shunting studies. Safety and efficacy have not been formally established in patients under 18 years of age by the FDA.
For microsphere therapy, renal impairment does not typically require a dose adjustment because the Yttrium is not excreted by the kidneys. However, for systemic Yttrium-90 (Zevalin), caution is advised as the chelate may have altered clearance in patients with severe kidney disease.
This is a critical area for Yttrium SIRT. Patients with a bilirubin level >2.0 mg/dL may be at higher risk for radiation-induced liver disease (RILD). Healthcare providers may reduce the dose or withhold treatment if liver function is severely compromised (Child-Pugh Class C).
Clinical trials have shown that patients over 65 respond similarly to younger patients. However, because elderly patients are more likely to have reduced hepatic reserve, healthcare providers often monitor liver function more frequently post-procedure.
Yttrium is never self-administered. It is a complex procedure performed in a hospital setting:
Because Yttrium is a scheduled hospital procedure, a 'missed dose' involves a missed appointment. If the procedure is delayed, the radiopharmaceutical must often be re-ordered because the isotope decays quickly (half-life of 64 hours). If you miss your appointment, contact your oncology team immediately to reschedule and manage the logistics of the radioactive material.
An overdose of Yttrium radiation can lead to severe radiation-induced liver disease (RILD) or 'Post-Radioembolization Syndrome.' Symptoms include severe abdominal pain, rapid liver failure, or fluid in the abdomen (ascites). Treatment is supportive, focusing on managing liver inflammation and maintaining fluid balance. Emergency measures include the administration of corticosteroids to reduce radiation-induced swelling.
> Important: Follow your healthcare provider's dosing instructions and pre-procedure guidelines exactly. Do not attempt to adjust your treatment schedule without medical guidance.
Most patients receiving Yttrium-90 microspheres experience Post-Radioembolization Syndrome (PRS). This is a cluster of symptoms caused by the localized radiation and the embolization of the tumor's blood supply.
Yttrium-90 is a radioactive material. While the radiation it emits (beta particles) has a short range, patients must follow specific safety protocols to protect others. For the first 3-7 days after a Yttrium procedure, you should avoid prolonged close contact (closer than 3 feet) with pregnant women or children. Always wash your hands thoroughly after using the bathroom, as trace amounts of radiation may be present in bodily fluids.
As noted in the side effects section, Yttrium-labeled Zevalin carries Black Box Warnings for Severe Infusion Reactions, Severe Cytopenias (blood cell loss), and Severe Mucocutaneous Reactions. There are currently no Black Box Warnings for Yttrium microspheres (TheraSphere/SIR-Spheres), though they are restricted to specialized medical facilities.
Conditions where Yttrium must NEVER be used include:
Yttrium-90 is classified as FDA Pregnancy Category X. This means that studies in animals or humans have demonstrated fetal abnormalities and the risk of the drug in pregnant women clearly outweighs any possible benefit. Women of childbearing age must have a negative pregnancy test before the procedure. Effective contraception must be used for at least 6 months following treatment. If a patient becomes pregnant while carrying Yttrium microspheres, they must be counseled on the high risk to the fetus.
It is unknown if Yttrium-90 is excreted in human milk. However, because of the potential for serious adverse reactions and radiation exposure to the nursing infant, breastfeeding is strictly contraindicated. For systemic Yttrium (Zevalin), breastfeeding should be discontinued permanently. For microspheres, it should be discontinued for at least 2 weeks or until the radiation has decayed significantly.
Yttrium is not FDA-approved for use in children. The long-term effects of internal radiation on a developing child's liver and bones are not well-studied. In rare cases of pediatric liver cancer, Yttrium may be used under 'compassionate use' protocols in major academic centers, with doses adjusted for the smaller liver volume.
Yttrium-90 is a pure beta-emitter. It decays by emitting a high-energy electron (beta particle) from its nucleus.
Common questions about Yttrium Iodide
Yttrium, specifically the radioactive isotope Yttrium-90, is primarily used to treat cancers that affect the liver, such as hepatocellular carcinoma and metastatic colorectal cancer. It is also used in a drug called Zevalin to treat certain types of Non-Hodgkin Lymphoma. In these roles, it delivers targeted radiation directly to tumor cells while sparing much of the surrounding healthy tissue. Beyond oncology, stable Yttrium is sometimes used in diagnostic tests for chemical allergies. It is always administered by specialists in a hospital setting.
The most common side effects are part of 'Post-Radioembolization Syndrome,' which includes significant fatigue, nausea, and mild abdominal pain. Many patients also experience a low-grade fever and a temporary loss of appetite for one to two weeks following the procedure. These symptoms are generally manageable with rest and supportive medications prescribed by your doctor. More serious but rare side effects include lung inflammation or stomach ulcers if the radioactive spheres travel outside the liver. Always report severe pain or yellowing of the skin to your medical team immediately.
No, you should strictly avoid alcohol for several months after receiving Yttrium-90 treatment. The liver is already under significant stress from the radiation and the process of clearing away dead tumor cells. Alcohol is a known toxin to liver cells and can significantly increase the risk of developing radiation-induced liver disease or permanent liver scarring. Your healthcare provider will monitor your liver function through blood tests and will tell you when, or if, it is safe to consume alcohol again. Following this restriction is crucial for your liver's recovery.
No, Yttrium-90 is not safe during pregnancy and is classified as FDA Category X. The high-energy beta radiation emitted by Yttrium can cause severe and permanent damage to a developing fetus, leading to birth defects or pregnancy loss. Women of childbearing age must have a confirmed negative pregnancy test before the procedure and use highly effective birth control for at least six months afterward. Men receiving the treatment should also discuss contraception with their doctor. If you suspect you are pregnant after receiving Yttrium, contact your oncologist immediately.
While the radiation from Yttrium-90 begins damaging cancer cells immediately after it is implanted, the results are not visible right away. It typically takes 4 to 12 weeks to see a reduction in tumor size on a CT or MRI scan. In some cases, the tumor may even look slightly larger on the first follow-up scan due to inflammation and swelling caused by the radiation. Doctors look for changes in the tumor's density and blood supply as early signs of success. Your oncology team will schedule regular imaging to track the long-term effectiveness of the treatment.
Yttrium treatment is not a daily medication that you can 'stop' taking; it is a permanent medical implant. Once the Yttrium-90 microspheres are injected into the liver, they remain there permanently, though their radioactivity disappears after about a month. There is no way to remove the spheres once they are in place. However, if you were scheduled for multiple treatment sessions, you and your doctor can decide to cancel or postpone future sessions if you experience severe side effects. There are no withdrawal symptoms associated with Yttrium therapy.
Because Yttrium is administered as a scheduled hospital procedure, a missed dose means a missed appointment. If you cannot make your appointment, you must notify your hospital's nuclear medicine or interventional radiology department as soon as possible. The Yttrium-90 isotope has a very short shelf life (half-life of 64 hours) and is often custom-ordered for your specific procedure date. If the appointment is missed, the radioactive material may decay and become unusable, requiring a new order and potentially delaying your treatment. Always keep your oncology team informed of any scheduling conflicts.
Yttrium treatment does not typically cause weight gain; in fact, weight loss is more common. Many patients experience a loss of appetite and nausea (Post-Radioembolization Syndrome) for a few weeks after the procedure, which can lead to temporary weight loss. However, if you notice rapid weight gain accompanied by a swelling abdomen or swelling in the legs, you should contact your doctor immediately. This could be a sign of ascites (fluid buildup), which can occur if the radiation causes significant stress or damage to the liver. Your doctor will monitor your weight and fluid levels during follow-up visits.
Yttrium can be used alongside many medications, but some require careful management. For example, oral chemotherapies like Sorafenib are usually stopped for a short period before and after the Yttrium procedure to protect the liver. Blood thinners must also be paused to prevent bleeding during the catheterization process. It is vital to provide your doctor with a complete list of all prescriptions, over-the-counter drugs, and herbal supplements you are taking. Your oncology team will provide a specific schedule for which medications to continue and which to pause.
Yttrium-90 is a radioactive isotope, and the products that deliver it (like TheraSphere and SIR-Spheres) are specialized medical devices rather than standard drugs. Currently, there are no 'generic' versions of these microspheres in the way there are generic versions of pills like ibuprofen. However, there are different brands and types (glass vs. resin) available. The choice of which product to use is made by the interventional radiologist based on the specific characteristics of your tumor and your liver health. These treatments are typically covered by major insurance plans and Medicare.
Other drugs with the same active ingredient (Yttrium)
> Warning: Stop following your normal routine and call your doctor immediately or seek emergency care if you experience any of these:
For Ibritumomab tiuxetan (Yttrium-90 Zevalin), the FDA has issued a Black Box Warning regarding:
Report any unusual symptoms to your healthcare provider immediately. Early intervention is key to managing Yttrium-related complications.
Following Yttrium therapy, patients require rigorous monitoring:
You should not drive yourself home after a Yttrium procedure due to the sedation used during the catheterization. In the days following, fatigue is common. Do not operate heavy machinery if you feel excessively tired or are taking prescription pain medications (opioids) for abdominal discomfort.
Alcohol should be strictly avoided for at least several weeks following Yttrium therapy. The liver is already under significant stress from the radiation and the dying tumor; alcohol can increase the risk of Radiation-Induced Liver Disease (RILD) and permanent scarring (cirrhosis).
Yttrium microsphere therapy is a one-time or few-time procedure, not a daily medication. There is no 'withdrawal' syndrome. However, if you are scheduled for multiple sessions (e.g., treating the right lobe then the left lobe), the second session may be canceled if your liver function does not recover sufficiently from the first dose.
> Important: Discuss all your medical conditions, especially any history of lung disease or stomach ulcers, with your healthcare provider before starting Yttrium.
For each major interaction, the mechanism usually involves additive toxicity (two things hurting the liver at once) or pharmacodynamic interference (competing for the body's recovery resources).
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including those for blood pressure, diabetes, or pain.
Conditions requiring careful risk-benefit analysis:
> Important: Your healthcare provider will evaluate your complete medical history, including your 'shunting' scan and liver function tests, before prescribing Yttrium.
Clinical data indicates that elderly patients (over 65) do not experience more side effects than younger patients. However, the 'liver reserve' (the ability of the liver to bounce back) is often lower in the elderly. Healthcare providers must be cautious with dosing in patients over 80 or those with significant 'polypharmacy' (taking many other medications).
Since Yttrium microspheres are not cleared by the kidneys, patients with mild to moderate renal impairment can usually undergo the procedure safely. However, those on dialysis require special coordination between the interventional radiologist and the nephrologist to ensure the catheterization procedure is timed correctly with their dialysis schedule.
This is the most critical special population. Dosing is often reduced by 25-50% for patients with moderate hepatic impairment (Child-Pugh Class B). Patients with Class C should generally not receive Yttrium. The goal is to treat the tumor without pushing the patient into 'end-stage' liver failure.
> Important: Special populations require individualized medical assessment and often a multidisciplinary board (Tumor Board) review.
| Parameter | Value |
|---|---|
| Bioavailability | 100% (Directly implanted) |
| Protein Binding | N/A (Microspheres) / High (Zevalin) |
| Half-life (Physical) | 64.1 Hours |
| Mean Tissue Penetration | 2.5 mm |
| Maximum Tissue Penetration | 11 mm |
| Excretion | Minimal (Physical decay to Zirconium-90) |
Yttrium-90 belongs to the class of Therapeutic Radiopharmaceuticals. Within the liver-directed therapy area, it is the primary agent for Selective Internal Radiation Therapy (SIRT). It is chemically related to other lanthanides and often grouped with 'Rare Earth' elements.