THALLOUS CHLORIDE Tl 201

5 WARNINGS AND PRECAUTIONS Hypersensitivity Reactions: Anaphylactic reactions characterized by cardiovascular, respiratory, and cutaneous symptoms may occur. Have resuscitation equipment and trained staff readily available. ( 5.1 ) Risk Associated with Stress Testing: Induction of cardiovascular stress may be associated with serious adverse reactions. Perform stress testing in a setting where cardiac resuscitation equipment and trained staff are readily available. ( 5.2 ) Radiation Risk: Ensure safe handling to minimize radiation exposure to patients and health care providers. ( 2.1 , 5.3 ) 5.1 Hypersensitivity Reactions Thallous Chloride Tl 201 Injection may cause anaphylactic reactions characterized by cardiovascular, respiratory, and cutaneous symptoms [see Adverse Reactions ( 6 )] . Have resuscitation equipment and trained staff readily available. 5.2 Risks Associated with Stress Testing Induction of cardiovascular stress might be associated with serious adverse reactions such as myocardial infarction, arrhythmia, hypotension or hypertension, ECG abnormalities, chest pain, bronchoconstriction, and cerebrovascular events [see Adverse Reactions ( 6 )] . Perform stress testing in the setting where cardiac resuscitation equipment and trained staff are readily available. Perform pharmacologic stress in accordance with the pharmacologic stress agent’s prescribing information. 5.3 Radiation Risk Thallous Chloride Tl 201 Injection contributes to a patient's overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to patients and health care providers. Advise patients to hydrate before and after administration and to void frequently after administration [see Dosage and Administration ( 2.1 , 2.3 )]. 5.4 Injection Site Reactions and Tissue Damage Injection site reactions and extravasation have been reported after administration of Thallous Chloride Tl 201 Injection [see Adverse Reactions ( 6 )] . Administer Thallous Chloride Tl 201 Injection strictly into the vein to avoid local tissue accumulation and irradiation. Confirm intravenous patency before injection.

6 ADVERSE REACTIONS The following clinically significant adverse reactions are described elsewhere in the labeling: Hypersensitivity Reactions [see Warnings and Precautions ( 5.1 )] Risk Associated with Stress Testing [see Warnings and Precautions ( 5.2 )] Injection Site Reactions and Tissue Damage [see Warnings and Precautions ( 5.4 )] The following adverse reactions associated with the use of Thallous Chloride Tl 201 Injection were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure: Cardiovascular, respiratory, and cerebrovascular disorders: myocardial infarction, arrhythmia, hypotension, bronchoconstriction, and cerebrovascular events in patients who have undergone stress testing Gastrointestinal disorders: nausea, vomiting, and diarrhea General disorders and administration site conditions: injection site reactions (burning, pain, redness, swelling, warmth, and tissue damage with chronic ulcer formation), chills, fever, and sweating Immune system disorders: hypersensitivity (anaphylaxis, hypotension, shortness of breath, pruritus, flushing, and diffuse rash) The following adverse reactions have been reported. In patients who have undergone stress testing: myocardial infarction, arrhythmia, hypotension, bronchoconstriction, and cerebrovascular events. Adverse reactions in other patients: nausea, vomiting, diarrhea, injection site reactions, chills, fever, sweating, hypersensitivity (anaphylaxis, hypotension, shortness of breath, pruritus, flushing, diffuse rash). ( 6 ) To report SUSPECTED ADVERSE REACTIONS, contact Curium US LLC at 1-866-789-2211 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.