NDC Code(s) : 45567-0555-1, 45567-0555-2
Packager : Sun Pharmaceutical Industries, Inc.

Category : HUMAN PRESCRIPTION DRUG LABEL

DEA Schedule : none

Marketing Status : New Drug Application

INGREDIENTS AND APPEARANCE

Kit for the Preparation of Technetium Tc99m SestamibiTECHNETIUM TC-99M SESTAMIBI INJECTION
Product Information
Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:45567-0555
Route of Administration INTRAVENOUS DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
TECHNETIUM TC-99M SESTAMIBI(UNII: 971Z4W1S09)
(TECHNETIUM TC-99M SESTAMIBI - UNII:971Z4W1S09)
TECHNETIUM TC-99M SESTAMIBI1 mg in 10 mL
Inactive Ingredients
Ingredient Name Strength
TRISODIUM CITRATE DIHYDRATE(UNII: B22547B95K)2.6 mg in 10 mL
CYSTEINE HYDROCHLORIDE(UNII: ZT934N0X4W)1 mg in 10 mL
MANNITOL(UNII: 3OWL53L36A)20 mg in 10 mL
STANNOUS CHLORIDE(UNII: 1BQV3749L5)0.075 mg in 10 mL
Packaging
# Item Code Package Description Marketing Start Date Marketing End Date
1NDC:45567-0555-15 in 1 CARTON 07/10/2009
110 mL in 1 VIAL Type 0: Not a Combination Product
2NDC:45567-0555-230 in 1 CARTON 07/10/2009
210 mL in 1 VIAL Type 0: Not a Combination Product
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA079157 07/10/2009

LABELER - Sun Pharmaceutical Industries, Inc.(139261648)

REGISTRANT - Sun Pharmaceutical Industries, Inc.(139261648)

Establishment
Name Address ID/FEI Business Operations
Sun Pharmaceutical Industries, Inc. 139261648 LABEL(45567-0555), PACK(45567-0555), ANALYSIS(45567-0555), MANUFACTURE(45567-0555)

PRINCIPAL DISPLAY PANEL

Kit for the Preparation of Technetium Tc99m Sestamibi Injection

1mg Cu(MIBI)4BF4 per Vial
For Intravenous Use after Reconstitution
Rx Only

Dosage: See Package Insert

Store at 20-25ºC (68-77ºF) [See USP] before and after reconstitution.
Use within 6 hours after reconstitution.

PL-000023

Rev 0.2

Mar 2020

Manufactured by:

Sun Pharmaceutical Industries, Inc.

Billerica, MA 01821

  •  Lot Exp
Vial Label

PRINCIPAL DISPLAY PANEL

CAUTION: RADIOACTIVE MATERIAL

See Package Insert for full prescribing information

Rx Only
Store: 20-25ºC
Use within 6 hours of reconstitution

Technetium Tc99m Sestamibi Injection

Contents
1mg Tetrakis (2-methoxy isobutyl isonitrile)
Copper (I) tetrafluoroborate [Cu(MIBI)4BF4]
2.6mg Sodium Citrate dihydrate
1mg L-Cysteine hydrochloride monohydrate
20mg Mannitol
0.025mg minimum stannous chloride dihydrate
0.075mg stannous chloride dihydrate
0.086mg maximum tin chloride (stannous and stannic) dihydrate
Sodium Pertechnetate Tc99m Injection

____________________________________________________
MBq (mCi) Tc99m/mL

____________________________________________________
Volume mL

____________________________________________________
Date / Time prepared Expiration Time

______________________
Lot No.

PL-000024

Rev 0.2

Mar 2020

Manufactured by:

Sun Pharmaceutical Industries, Inc.

Billerica, MA 01821

Shield Label

PRINCIPAL DISPLAY PANEL

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

1mg Cu(MIBI)4BF4 per Vial
For Intravenous Use after
Reconstitution

Rx Only

Nonradioactive • Diagnostic Agent • Multidose

Sterile • Non-Pyrogenic

Vial contents are sealed under Nitrogen
at time of manufacture. The pH of
the reconstituted product is 5.5

Dosage: See Package Insert

Manufactured by:

Sun Pharmaceutical Industries, Inc.

Billerica, MA 01821
For Customer Service call: 1-800-221-7554

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

for:

Myocardial or Breast Imaging

Rx Only
Each sterile, lyophilized vial contains: 1mg Tetrakis
(2-methoxy isobutyl isonitrile) Copper (I) tetrafluoroborate
[Cu(MIBI)4BF4]; 2.6mg Sodium Citrate dihydrate; 1mg
L-Cysteine Hydrochloride monohydrate; 20mg Mannitol;
0.025mg minimum stannous chloride dihydrate; 0.075mg stannous
chloride dihydrate; 0.086mg maximum tin chloride (stannous
and stannic) dihydrate. pH of reconstituted product is 5.5

CONTAINS NO PRESERVATIVE
Reconstitute with oxidant-free Tc99m

Before reconstitution and after labeling
with oxidant-free Technetium Tc 99m,
store at 20-25°C (68-77°F) [See USP]

After labeling store in a suitable lead shield
and use within 6 hours (see insert).

Contents: 1 package insert, 12 radiation

labels and 5 reaction vials

Preparation: See Package Insert for complete

information, use and directions

Kit for the
Preparation of
Technetium Tc99m
Sestamibi
Injection

IMPORTANT:

Read Package Insert for full
information on preparation,
use and indications.

WARNING:

Radiopharmaceuticals should
be used by persons who are
qualified by specific training
in the safe use and handling
of radionuclides and whose
experience and training have
been approved by the
appropriate governmental
agency.
PL-000025

Rev 0.3

Mar 2020

5 Vial Carton

PRINCIPAL DISPLAY PANEL

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

1mg Cu(MIBI)4BF4 per Vial

for

Myocardial or Breast Imaging

For Intravenous Use after Reconstitution

Rx Only

Nonradioactive • Diagnostic Agent • Multidose
Sterile • Non-Pyrogenic

Vial contents are sealed under Nitrogen
at time of manufacture. The pH of
the reconstituted product is 5.5

Dosage: See Package Insert

Manufactured by:

Sun Pharmaceutical Industries, Inc.

Billerica, MA 01821
For Customer Service call: 1-800-221-7554

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

Contents: 1 Package Insert, 72 radiation labels and 30 reaction vials

Each sterile, lyophilized vial contains: 1mg Tetrakis (2-methoxy isobutyl isonitrile) Copper (I) tetrafluoroborate [Cu(MIBI)4BF4]; 2.6mg Sodium Citrate dihydrate; 1mg L-Cysteine Hydrochloride monohydrate; 20mg Mannitol; 0.025mg minimum stannous chloride dihydrate; 0.075mg stannous chloride dihydrate; 0.086mg maximum tin chloride (stannous and stannic) dihydrate. pH of reconstituted product is 5.5

CONTAINS NO PRESERVATIVE • Reconstitute with oxidant-free Tc99m

Before reconstitution and after labeling with oxidant-free Technetium Tc 99m,
store at 20-25°C (68-77°F) [See USP]

After labeling store in a suitable lead shield and use within 6 hours (see insert).

Preparation: See Package Insert for complete information, use and directions

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

1mg Cu(MIBI)4BF4 per Vial

For Intravenous Use after Reconstitution

Rx Only

Kit for the
Preparation of Technetium Tc99m
Sestamibi Injection

IMPORTANT:

Read Package Insert for full information on preparation, use and indications.

WARNING:

Radiopharmaceuticals should be used by persons who are qualified by specific
training in the safe use and handling of radionuclides and whose experience and
training have been approved by the appropriate governmental agency.

Manufactured by:

Sun Pharmaceutical Industries, Inc.

Billerica, MA 01821
For Customer Service call: 1-800-221-7554

PL-000026

Rev 0.3

Mar 2020

30 Vial Carton