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Overview: Lutetium lu 177 dotatate is a radioactive medicine used to treat certain neuroendocrine tumors that have proteins called somatostatin receptors. The medicine attaches to these receptors and delivers radiation directly to the tumor cells, which can damage or kill the cells. Lutetium Lu 177 dotatate is given as an intravenous infusion by a health care provider. Treatment can cause serious side effects, including radiation exposure, low blood cell counts, kidney or liver problems, and raise the risk of certain blood cancers. To help limit radiation exposure to those around you, follow the safety instructions from your health care provider.

Uses

What is lutetium lu 177 dotatate used for?

Lutetium lu 177 dotatate is commonly used to treat certain types of tumors in the digestive system called gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

What to Know About Lutathera for Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) 

Lutetium lu 177 dotatate may also be used for other conditions as determined by your health care provider.

How does lutetium lu 177 dotatate work (mechanism of action)?

Lutetium lu 177 dotatate works by targeting cells with special proteins on them called somatostatin receptors. The medicine attaches to these receptors and delivers a dose of radiation into the cell. This damages the tumor and nearby cells, which can slow or stop the growth of tumors.

How is lutetium lu 177 dotatate supplied (dosage forms)?

Brands and other names

  • Lutathera

  • Bexlutry

  • Bravnetsa

Dosage forms and strengths

  • Lutetium lu 177 dotatate is available in an injectable form that is given by a health care provider.

How should I store lutetium lu 177 dotatate?

Lutetium lu 177 dotatate is given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of lutetium lu 177 dotatate?

The most common side effects of lutetium lu 177 dotatate are listed below. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of lutetium lu 177 dotatate that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of lutetium lu 177 dotatate?

While less common, the most serious side effects of lutetium lu 177 dotatate are described below, along with what to do if they happen.

Severe Allergic Reactions. Lutetium lu 177 dotatate may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Disorders. Lutetium lu 177 dotatate can cause blood disorders, such as low white blood cells (leukopenia or neutropenia), low platelets (thrombocytopenia), and low red blood cells (anemia). Tell your health care provider right away if you have any of the following symptoms of blood disorders.

  • Fever, chills, or sweats
  • Sore throat, cough, or shortness of breath
  • Frequent infections
  • Easy bruising or bleeding
  • Unusual weakness or tiredness
  • Dizziness, feeling lightheaded, or fainting
  • Shortness of breath
  • Fast or abnormal heartbeat

Blood Disorder or Cancer. Lutetium lu 177 dotatate may increase the risk of myelodysplastic syndromes, which are blood disorders where your body does not make enough healthy blood cells. Lutetium lu 177 dotatate may also raise the risk of leukemia, which is a type of blood cancer. These conditions have been reported by a small number of people who used this medicine, and most cases occurred months to years later. Keep all appointments to check your blood work after lutetium lu 177 dotatate treatment.

Kidney Damage. Kidney damage can happen when using lutetium lu 177 dotatate. Tell your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Trouble catching your breath or chest pain or pressure
  • Confusion
  • Nausea
  • Seizures

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using lutetium lu 177 dotatate. Tell your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored pee
  • Yellowish skin or eyes (jaundice)

Increased Hormones in the Body. Lutetium lu 177 dotatate may cause your tumors to release large amounts of hormones into your body, known as neuroendocrine hormonal crisis. While uncommon, this may lead to symptoms during or within 24 hours after your first dose of lutetium lu 177 dotatate. Tell your health care provider right away if you have the following symptoms of hormonal crisis. 

Warnings & Precautions

Who should not use lutetium lu 177 dotatate?

Allergies to Ingredients. People who are allergic to any of the following should not use lutetium lu 177 dotatate.

  • Bexlutry
  • Bravnetsa
  • Lutathera
  • Lutetium lu 177 dotatate
  • Any of the ingredients in the specific product

Your health care provider can tell you all of the ingredients in lutetium lu 177 dotatate.

What should I know about lutetium lu 177 dotatate before using it?

Lutetium lu 177 dotatate vwill be given to you by a health care provider in a hospital, clinic, or infusion center. 

Treatment with lutetium lu 177 dotatate exposes you to radiation, which adds to your overall radiation exposure. Higher exposure to radiation may increase your long-term risk of getting cancer. 

Radiation from lutetium lu 177 dotatate can be found in your urine (pee) for up to 30 days after receiving the medicine. To help limit radiation exposure to those around you, follow the safety instructions from your health care provider, such as flushing the toilet twice after each use and using a separate bathroom if possible. Always wash your hands after using the bathroom.

Lutetium lu 177 dotatate may affect your ability to become pregnant or get a partner pregnant in the future. Talk with your health care provider if you have concerns about this.

What should I tell my health care provider before using lutetium lu 177 dotatate?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if lutetium lu 177 dotatate is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney problems or risk factors for kidney problems, such as diabetes or high blood pressure
  • Tumors that have spread to your liver
  • Past radiation treatment or exposure

Other Medicines and Supplements. Lutetium lu 177 dotatate may interact with other medicines and supplements. Before starting this treatment, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Breastfeeding. It is not known if lutetium lu 177 dotatate passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. You should not breastfeed during treatment and for 2.5 months after your last dose of lutetium lu 177 dotatate.

Pregnancy. Lutetium lu 177 dotatate may cause harm to a fetus. Tell your health care provider if you or your partner is pregnant or planning to become pregnant. Your health care provider may give you a pregnancy test to make sure you are not pregnant before you use lutetium lu 177 dotatate.

If you can become pregnant, it is recommended to use birth control during lutetium lu 177 dotatate treatment and for 7 months after your last dose. If your partner can become pregnant, use birth control (such as condoms) during lutetium lu 177 dotatate treatment and for 4 months after your last dose.

Interactions

Does lutetium lu 177 dotatate interact with foods or drinks?

There are no known interactions between lutetium lu 177 dotatate and foods or drinks.

It is unknown if drinking alcohol will affect lutetium lu 177 dotatate. 

Does lutetium lu 177 dotatate interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before starting lutetium lu 177 dotatate.

  • A long-acting somatostatin analog within the past four weeks, such as octreotide (Sandostatin LAR Depot) or lanreotide (Somatuline Depot), which is a medicine for certain hormone disorders and tumors
  • A short-acting somatostatin analog within the past 24 hours, such as octreotide (Sandostatin, Bynfezia, and others), which is a medicine used to treat certain hormone disorders and tumors
  • A corticosteroid, such as prednisone, which is a medicine for certain inflammatory conditions

This may not be a complete list of medicines that can interact with lutetium lu 177 dotatate. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much lutetium lu 177 dotatate?

If you or someone else has used too much lutetium lu 177 dotatate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of lutetium lu 177 dotatate?

Lutetium lu 177 dotatate is given by a health care provider in a hospital or clinic. If you miss an appointment to get your dose of lutetium lu 177 dotatate, call to make another appointment as soon as possible.