{"entity":{"id":"tc-99m-mdp","kind":"drug","name":"Technetium Tc-99m medronate (MDP)","aka":["99mTc-MDP","Technetium Tc 99m Medronate","CIS-MDP","Draximage MDP-25"],"tldr":"The standard, decades-old bone scan: a radioactive tracer that sticks to areas of bone rebuilding, so a gamma-camera picture afterwards shows where cancer may have spread to bone, or where a fracture or infection is healing.","summary":"Technetium Tc 99m Medronate is supplied as a cold kit -- a vial of medronic acid and stannous chloride that the radiopharmacy reconstitutes with the hospital's own technetium-99m generator eluate -- under several long-approved NDAs (e.g. Draximage MDP-25, NDA 018035; CIS-MDP, NDA 018124). It is indicated broadly as a bone imaging agent to delineate areas of altered osteogenesis, without an oncology-specific label claim, but the single largest clinical use remains detecting osteoblastic skeletal metastases, chiefly from prostate and breast cancer, alongside benign indications such as fracture, infection and metabolic bone disease.\n\nThe recommended adult dose is 370-740 MBq (10-20 mCi) IV, with optimal imaging 1-4 hours later; about half the injected dose is retained in the skeleton and half is excreted in urine within 24 hours. The label carries no listed contraindications but flags allergic dermatological reactions reported with the diphosphonate class, and a 2025 label update added a warning about altered biodistribution in the presence of high levels of certain cations (iron, calcium, aluminium). Despite the rise of 18F-NaF PET and, in prostate cancer, PSMA PET, 99mTc-MDP bone scintigraphy remains the most widely available and lowest-cost skeletal survey worldwide.","status":"approved","asOf":"2026-09-22","links":[{"label":"FDA label: Draximage MDP-25 (Kit for the Preparation of Technetium Tc 99m Medronate Injection)","url":"https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/018035s043lbl.pdf"},{"label":"FDA label: CIS-MDP (Kit for the Preparation of Technetium Tc 99m Medronate)","url":"https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/018124s013lbl.pdf"}],"tags":["bone scan","SPECT","cold kit","generic"],"related":["f-18-naf","f-18","tc-99m"],"indications":["prostate"],"sections":[],"technologies":["spect","spect-ct","radionuclide-generators-kits"],"targets":[],"drugs":[],"companies":["curium","ge-healthcare"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"modality":"SPECT tracer","mechanism":"Medronate (methylene diphosphonate) is a bisphosphonate that chelates technetium-99m and, once injected, adsorbs onto the hydroxyapatite crystal surface of bone in proportion to local osteoblastic activity and blood flow -- the same underlying biology as 18F-NaF PET, but imaged with a conventional gamma camera or SPECT rather than PET.","approvals":[{"region":"US","year":1972,"indication":"Bone imaging agent to delineate areas of altered osteogenesis"}],"mechanismSteps":[],"dosing":{"route":"Intravenous injection over ~30 seconds, after kit reconstitution","schedule":"370-740 MBq (10-20 mCi) in an average 70 kg adult; optimal imaging 1-4 hours post-injection","source":"https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/018035s043lbl.pdf"},"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/tc-99m-mdp/","neighbours":{"drug":[{"id":"f-18-naf","kind":"drug","name":"Sodium fluoride F-18","route":"/drugs/f-18-naf/"}],"isotope":[{"id":"f-18","kind":"isotope","name":"Fluorine-18","route":"/isotopes/f-18/"},{"id":"tc-99m","kind":"isotope","name":"Technetium-99m","route":"/isotopes/tc-99m/"}],"indication":[{"id":"nsclc","kind":"indication","name":"Non-small cell lung cancer","route":"/indications/nsclc/"},{"id":"prostate","kind":"indication","name":"Prostate cancer","route":"/indications/prostate/"}],"technology":[{"id":"radionuclide-generators-kits","kind":"technology","name":"Radionuclide generators and cold kits","route":"/technologies/radionuclide-generators-kits/"},{"id":"spect","kind":"technology","name":"SPECT & bone scan","route":"/technologies/spect/"},{"id":"spect-ct","kind":"technology","name":"SPECT/CT","route":"/technologies/spect-ct/"}],"company":[{"id":"curium","kind":"company","name":"Curium","route":"/companies/curium/"},{"id":"ge-healthcare","kind":"company","name":"GE HealthCare","route":"/companies/ge-healthcare/"}]}}