Pronunciation:

PRUSH-un bloo

Brand Names:

• Radiogardase

Dosage Forms:

• Capsule

Classifications:

Therapeutic—

Pigmentation Agent

Uses of This Medicine:

Prussian blue is used to treat radioactive cesium or thallium, or non-radioactive thallium poisoning. It works by combining with thallium and cesium in the intestines. The combination is then removed from the body through the stools. By removing the thallium or radiocesium, the medicine lessens damage to your body's organs and tissues.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of Prussian blue in children younger than 2 years of age. Safety and efficacy have not been established.

Older adults—

Although appropriate studies on the relationship of age to the effects of Prussian blue have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related heart problems, which may require caution in patients receiving Prussian blue.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Arrhythmia (heart rhythm problem) or
• Electrolyte imbalance—Use with caution. May make these conditions worse.

• Blockage of the intestines or
• Constipation or
• Stomach or bowel problems—May increase risk for constipation.

• Liver disease—May not work properly in patients with this condition.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Take this medicine with food.

Follow your doctor's instructions on proper handwashing, toilet use, and handling of items such as clothing that may be contaminated with body fluids while using this medicine.

If you are unable to swallow the capsule, you may open the capsule, empty the contents, and mix with bland food or liquids.

Your doctor may advise you to take this medicine with a laxative, such as sorbitol, to help prevent constipation.

Keep using this medicine for the full time of treatment, even if you begin to feel better after a few days. Do not miss any doses.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (capsules):
  • For cesium poisoning:
    • Adults and teenagers—3 grams (6 capsules) three times a day.
    • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.
  • For thallium poisoning:
    • Adults and teenagers—3 grams (6 capsules) three times a day.
    • Children 2 to 12 years of age—1 gram (2 capsules) three times a day.
    • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood, urine, and other laboratory exams may be needed to check for unwanted effects.

This medicine may decrease gastrointestinal motility, which can increase the radiation absorbed dose to your stomach. Check with your doctor right away if you have constipation while using this medicine.

This medicine may cause hypokalemia (low potassium in the blood). Check with your doctor right away if you have dry mouth, increased thirst, muscle cramps, nausea or vomiting, or uneven heartbeat while using this medicine.

This medicine may cause your stools to appear in color blue. This is normal and nothing to worry about. Also, if you open the capsules and mixed them with food, your mouth and teeth may be colored blue.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Convulsions

decreased urine

difficulty having a bowel movement (stool)

dry mouth

increased thirst

irregular heartbeat

loss of appetite

mood changes

muscle pain or cramps

nausea or vomiting

numbness or tingling in the hands, feet, or lips

shortness of breath

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Blue colored stools

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.