# Iobenguane I-123

Source: https://nuclide.cc/drugs/i-123-mibg/  
Nuclide record `i-123-mibg` (Agent). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

An injectable tracer that mimics a stress hormone and gets taken up by certain nerve-related tumours, such as pheochromocytoma and childhood neuroblastoma, so a scan afterwards can show where they are.

## Summary

AdreView (Iobenguane I 123 Injection) was approved by FDA in 2008 for detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests, and gained a second, unrelated cardiac indication in 2013 (assessment of myocardial sympathetic innervation in heart failure via the heart-to-mediastinum ratio). The adult dose is 10 mCi (370 MBq) IV, and patients require thyroid-blocking medication beforehand to prevent free iodine-123 accumulating in the thyroid.

The most common adverse reactions in the pivotal trials -- dizziness, rash, pruritus, flushing, headache and injection-site haemorrhage -- occurred in under 1.3% of patients, and the product is contraindicated only in known hypersensitivity to iobenguane or iobenguane sulfate. It contains benzyl alcohol as a preservative, which carries a specific warning against use in premature or low-birth-weight infants ("gasping syndrome"). In oncology, 123I-MIBG scintigraphy remains part of SNMMI/EANM guideline workups for pheochromocytoma/paraganglioma and paediatric neuroblastoma, though 18F-FDOPA and 68Ga-DOTATATE PET have overtaken it in sensitivity for many indications, and 131I-MIBG is the therapeutic counterpart used once MIBG uptake is confirmed.

## Fields

- Kind: Agent
- Status: approved
- Last checked: 2026-09-22
- Also known as: 123I-MIBG; AdreView; Iobenguane I 123 Injection
- Tags: MIBG; SPECT; pheochromocytoma; neuroblastoma
- Brand: AdreView
- Modality: SPECT tracer
- Mechanism: Iobenguane (meta-iodobenzylguanidine, MIBG) is structurally related to noradrenaline and is taken up by the noradrenaline transporter into sympathetic neurons and neuroendocrine cells derived from the neural crest, including pheochromocytoma, paraganglioma and neuroblastoma cells. Labelling with the gamma emitter iodine-123 allows whole-body gamma-camera or SPECT imaging.
- Approvals: US 2008: Detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests; US 2013: Scintigraphic assessment of myocardial sympathetic innervation in NYHA class II/III heart failure with LVEF <=35% (non-oncology indication)
- Dosing: Intravenous injection over 1-2 minutes; 10 mCi (370 MBq) for patients >=16 years or <16 years and >=70 kg; weight-scaled dose otherwise; thyroid blockade required beforehand

## Sources

- FDA label: AdreView (Iobenguane I 123 Injection): https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/022290s005lbl.pdf
- FDA supplemental approval letter, NDA 22-290 (2013 cardiac indication): https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2013/022290orig1s001ltr.pdf

## Connected records

- drugs: [131I-MIBG (iobenguane I-131) therapy](https://nuclide.cc/drugs/i131-mibg/), [Fluorodopa F-18](https://nuclide.cc/drugs/f-18-fdopa/), [Iobenguane I-131 (therapeutic)](https://nuclide.cc/drugs/iobenguane-i-131/)
- isotopes: [Fluorine-18](https://nuclide.cc/isotopes/f-18/), [Gallium-68](https://nuclide.cc/isotopes/ga-68/), [Iodine-123](https://nuclide.cc/isotopes/i-123/), [Iodine-131](https://nuclide.cc/isotopes/i-131/)
- indications: [Metastatic pheochromocytoma and paraganglioma](https://nuclide.cc/indications/metastatic-ppgl/), [Neuroblastoma (paediatric)](https://nuclide.cc/indications/neuroblastoma/), [Pheochromocytoma and paraganglioma (PPGL)](https://nuclide.cc/indications/pheochromocytoma-paraganglioma/)
- technologies: [MIBG imaging and 131I-MIBG therapy](https://nuclide.cc/technologies/mibg-theranostics/), [SPECT & bone scan](https://nuclide.cc/technologies/spect/)
- companies: [GE HealthCare](https://nuclide.cc/companies/ge-healthcare/)

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