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Sodium Iodide I-131
Sodium Iodide I-131 is a radioactive isotope used for both diagnostic and therapeutic purposes in managing certain thyroid conditions. It is primarily used to treat hyperthyroidism (overactive thyroid), Graves’ disease, and thyroid cancer. Sodium Iodide I-131 works by being absorbed by the thyroid gland, where the radiation emitted by I-131 selectively destroys thyroid tissue or cancer cells. It is also used in smaller doses for thyroid scans to assess thyroid function or structure.
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Frequently Asked Questions
How long does it take for Sodium Iodide I-131 to work?
For hyperthyroidism, it typically takes several weeks to months for the full effect to be realized, as the thyroid tissue gradually absorbs the radiation and shrinks. For thyroid cancer, follow-up scans and blood tests will determine the effectiveness of the treatment.
Will I need to stay in the hospital after receiving I-131?
Most patients receiving I-131 for hyperthyroidism can return home the same day. However, those receiving higher doses for thyroid cancer may need to stay in the hospital temporarily for radiation safety precautions.
Can I be around others after I-131 treatment?
After receiving I-131, you will be mildly radioactive for a few days. You will be instructed to avoid close contact with others, particularly pregnant women and young children, for a specified period to reduce their exposure to radiation.
Will I need to take thyroid medication after I-131 therapy?
Yes, many patients will develop hypothyroidism after I-131 treatment and will need to take thyroid hormone replacement (levothyroxine) for life to maintain normal thyroid function.
Can I eat normally before and after I-131 treatment?
Before treatment, you may be advised to follow a low-iodine diet to help improve the absorption of the radioactive iodine. After treatment, follow your doctor's instructions regarding diet and medications.
Comprehensive Drug Guide
How Does Sodium Iodide I-131 Work?
Sodium Iodide I-131 is absorbed by the thyroid gland, where it emits beta and gamma radiation. The beta radiation works by selectively destroying thyroid tissue or cancer cells, while the gamma radiation allows for imaging and diagnostic purposes. By targeting the thyroid specifically, I-131 treats overactive thyroid conditions and certain thyroid cancers by reducing the size and function of the gland.
Common Dosages
- For hyperthyroidism: Doses typically range from 5 to 30 mCi (millicuries).
- For thyroid cancer: Higher doses ranging from 30 to 200 mCi may be used.
- For diagnostic thyroid scans: Much lower doses (typically 1 to 5 mCi) are used for imaging.
Typical Dosing
- For hyperthyroidism: A single dose of Sodium Iodide I-131 is usually sufficient to reduce thyroid activity. The exact dose will depend on the size and activity of the thyroid gland.
- For thyroid cancer: Multiple doses may be required, especially for metastatic or advanced cases.
- For diagnostic use: A small dose is administered to capture images of the thyroid and evaluate its function.
Typical Dosing
FDA Approved Indications
- Hyperthyroidism (including Graves’ disease and toxic nodular goiter)
- Thyroid cancer (specifically differentiated thyroid cancer)
It is also used for:
- Thyroid function testing in smaller, diagnostic doses.
Who Shouldn't Take Sodium Iodide I-131?
- Pregnancy: I-131 is contraindicated in pregnant women as it can cause harm to the fetus, particularly affecting the thyroid development of the unborn child.
- Breastfeeding: Women should not breastfeed while receiving I-131, as it can be passed through breast milk.
- Severe uncontrolled thyroid storm: Use of I-131 in such cases should be approached cautiously.
Advice From The Pharmacist
- Sodium Iodide I-131 is administered under the supervision of a healthcare provider, usually in a hospital or clinic setting.
- After receiving I-131 therapy, patients are typically advised to avoid close contact with others, especially pregnant women and young children, for a few days due to the residual radiation emitted from their body.
- Drink plenty of fluids after receiving I-131 to help flush out any remaining radioactive material from the body.
- You may need to discontinue certain thyroid medications or supplements before receiving I-131, as these can interfere with the treatment.
Side Effects of Sodium Iodide I-131
Common Side Effects
- Dry mouth or sore throat
- Swelling or tenderness of the salivary glands
- Nausea or mild stomach discomfort
- Altered taste or metallic taste in the mouth
Uncommon/Severe Side Effects
- Hypothyroidism: I-131 often results in an underactive thyroid, requiring lifelong thyroid hormone replacement therapy.
- Radiation thyroiditis: Inflammation of the thyroid following treatment, leading to temporary swelling and pain.
- Sialadenitis: Inflammation of the salivary glands, which can cause pain, swelling, and dry mouth.
- Radiation exposure risks: Prolonged exposure to people around you may pose radiation risks, hence the need for isolation precautions.
Risks and Warnings of Sodium Iodide I-131
- Pregnancy Risk: Sodium Iodide I-131 is strictly contraindicated in pregnancy due to the risk of fetal thyroid damage. Women of childbearing potential should have a negative pregnancy test before administration and avoid pregnancy for at least 6 months after treatment.
- Hypothyroidism: Most patients treated with I-131 for hyperthyroidism will develop hypothyroidism over time, requiring lifelong thyroid hormone replacement.
- Radiation Precautions: After treatment, patients must follow radiation safety guidelines, such as avoiding close contact with others and sleeping alone, to minimize radiation exposure to family members and others.
Interactions with Sodium Iodide I-131
Common Drug Interactions
- Thyroid medications: Medications like levothyroxine or methimazole should be discontinued before I-131 treatment to optimize its efficacy.
- Iodine-containing supplements: Avoid iodine supplements or foods rich in iodine (e.g., seaweed) before and after treatment, as excess iodine can interfere with I-131 uptake.
Alternatives to Sodium Iodide I-131
- Antithyroid medications (e.g., methimazole, propylthiouracil): These drugs reduce thyroid hormone production and may be used in patients who cannot tolerate I-131 or prefer non-radioactive treatments.
- Surgical thyroidectomy: For patients with thyroid cancer or those who cannot undergo I-131 therapy, surgical removal of the thyroid may be an option.
- Thyroid hormone replacement: For patients who develop hypothyroidism after I-131 therapy, thyroid hormone replacement with levothyroxine is necessary.
