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ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

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About the medicine

How to use ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the Patient

Erbium Citrate (169Er) Colloidal CIS bio international 111 MBq/ml Injectable Suspension

Erbium Citrate (169Er)

Read this entire leaflet carefully before starting to use this medication because it contains important information for you..

  • Keep this leaflet, as you may need to read it again.
  • If you have any questions, consult the nuclear medicine doctor who is supervising the procedure.
  • If you experience side effects, consult the nuclear medicine doctor, even if they are side effects not listed in this leaflet. See section 4.

Contents of the Leaflet:

1. What is Erbium Citrate (169Er) Colloidal CIS bio international and what is it used for

2. Before using Erbium Citrate (169Er) Colloidal CIS bio international

3. How to use Erbium Citrate (169Er) Colloidal CIS bio international

4. Possible side effects

5. Storage of Erbium Citrate (169Er) Colloidal CIS bio international

6. Package Contents and Additional Information

1. What is Erbium Citrate (169Er) Colloidal CIS bio international and what is it used for

This medication is a radiopharmaceutical for therapeutic use only.

Erbium Citrate (169Er) Colloidal CIS bio international is indicated in adults for the treatment of arthritis during inflammatory flare-ups of small joints in the hands and feet, when intra-articular treatment with corticosteroids fails or is contraindicated.

Administration of Erbium Citrate (169Er) Colloidal CIS bio international involves receiving a small amount of radioactivity. Your doctor and the nuclear medicine doctor consider that the clinical benefit you will obtain from this procedure with the radiopharmaceutical outweighs the risk due to radiation.

Doctor consultation

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2. What you need to know before starting to use Erbium Citrate (169Er) Colloidal CIS bio international

Erbium Citrate (169Er) Colloidal CIS bio international must not be used:

  • If you are allergic (hypersensitive) to Erbium Citrate (169Er) or to any of the other components of this medication (listed in section 6).
  • If you are pregnant or think you may be pregnant.
  • If you are breastfeeding your child.
  • In children and young patients under 20 years of age.
  • If you have an infection in the joint to be treated.
  • If you have local infections or skin disorders in the injection area.
  • If you have recently had a synovial cyst rupture.

Warnings and Precautions

Be especially careful with Erbium Citrate (169Er) Colloidal CIS bio international and consult the nuclear medicine specialist:

  • If you have undergone a procedure with X-ray contrast media in the last 3 days
  • If you are a woman of childbearing age

Before administration ofErbium Citrate (169Er) Colloidal CIS bio internationalyou should avoid pregnancy by using an effective contraceptive method for several months after treatment.

Children and Adolescents

Inform your nuclear medicine specialist if you are under 20 years of age.

Use of Erbium Citrate (169Er) Colloidal CIS bio international with other medications:

Inform the nuclear medicine specialist if you are taking, have recently taken, or may need to take any other medication, including those purchased without a prescription.

Inform your nuclear medicine doctor if you have undergone a procedure with X-ray contrast media in the last 3 days, as it may interfere with the treatment outcome.

Pregnancy and Breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your nuclear medicine specialist before receiving this medication.

You must inform your nuclear medicine doctor before administration of Erbium Citrate (169Er) Colloidal CIS bio international if there is any possibility that you are pregnant, if you have a delayed period, or if you are breastfeeding. In fact, Erbium Citrate (169Er) should not be administered to pregnant or breastfeeding women. If you are a woman of childbearing age, you should use effective contraceptive measures before receiving this medication and maintain them for several months after treatment.

In case of doubt, it is essential to consult the nuclear medicine specialist who will supervise the procedure.

Driving and Using Machines

Driving vehicles or using machines is not recommended due to joint immobilization after administration.

Erbium Citrate (169Er) Colloidal CIS bio international contains less than 23 mg of sodium (1mmol) per dose; this is essentially "sodium-free".

3. How to use Erbium Citrate (169Er) Colloidal CIS bio international

There are strict rules for the use, handling, and disposal of radiopharmaceuticals. Erbium Citrate (169Er) Colloidal CIS bio international will only be used in controlled facilities. This product will only be handled and administered by trained and qualified personnel to use it safely. These individuals will take special care in the safe use of this product and will inform you of their actions.

The nuclear medicine doctor who supervises the procedure will decide the amount of Erbium Citrate (169Er) Colloidal CIS bio international to be used in your case. This will be the minimum amount necessary to achieve the desired effect. The generally recommended amount for administration to an adult is 10 to 80 MBq (Megabecquerel, the unit used to express radioactivity) depending on the joint to be treated.

Administration ofErbium Citrate (169Er) Colloidal CIS bio international and performance of the procedure

Erbium Citrate (169Er) Colloidal CIS bio international is injected directly into the small joints of the hands and feet by your nuclear medicine doctor.

Several joints can be treated simultaneously or successively.

A repeat injection of the radiopharmaceutical into a joint should not be done until at least six months have passed.

After administration of Erbium Citrate (169Er) Colloidal CIS bio international, you should:

  • Have the joint immobilized for 2 days (splints or bed rest)
  • Use an effective contraceptive method for several months after treatment to avoid any pregnancy.

Your nuclear medicine doctor will inform you if you need to take any precautions after receiving this medication. Consult your nuclear medicine doctor if you have any questions.

If you have received moreErbium Citrate (169Er) Colloidal CIS bio internationalthan you should have:

Overdose is unlikely because you will receive a single dose of Erbium Citrate (169Er) Colloidal CIS bio international per joint, controlled with precision by the nuclear medicine doctor who supervises the procedure. However, in case of overdose, you will receive appropriate treatment.

If you have any questions about the use of Erbium Citrate (169Er) Colloidal CIS bio international, ask the nuclear medicine doctor who supervises the procedure.

Medicine questions

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4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone will experience them.

The most frequently observed side effects after synoviorthesis with Erbium Citrate (169Er) Colloidal CIS bio international are:

  • Very common (may affect more than 1 in 10 people): pain, inflammation at the injection site, acute arthritis (reappearance of inflammation during the first week after administration).
  • Common (may affect up to 1 in 10 people): fever, dysfunction of joint mobility, skin pigmentation.
  • Very rare (may affect up to 1 in 10,000 people): redness, severe skin disorder with blisters.
  • Frequency not known (cannot be estimated from available data): secondary infection in the joint, joint inflammation, skin necrosis, rash, and itching.

This radiopharmaceutical will release small amounts of ionizing radiation, which is minimally associated with the risk of cancer or genetic defects.

Reporting side effects

If you experience any type of side effect, inform your nuclear medicine specialist, even if it is a side effect not included in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es.

By reporting side effects, you can contribute to providing more information on the safety of this medication.

5. Storage of Erbium Citrate (169Er) Colloidal CIS bio international

You will not need to store this medication. This medication is stored under the responsibility of the specialist in appropriate facilities. The storage of radiopharmaceuticals will be carried out in accordance with national regulations on radioactive materials.

6. Package Contents and Additional Information

Composition ofErbium Citrate (169Er) Colloidal CIS bio international

  • The active ingredient is Erbium Citrate (169Er).
  • The other components are: nitric acid, sodium hydroxide, sodium chloride, and water for injectable preparations.

Appearance of Erbium Citrate (169Er) Colloidal CIS bio international and package contents

Erbium Citrate (169Er) Colloidal CIS bio international is presented as an injectable suspension, in a multidose vial.

Package size: 15 ml glass vials, sealed with a rubber stopper and aluminum cap. Contains between 0.1 and 10.0 ml, corresponding to an activity between 11 and 1110 MBq at the calibration date and time.

Marketing Authorization Holder and Manufacturer:

CIS bio international

RN 306 - Saclay

B.P. 32

F-91192 Gif-sur-Yvette Cedex

FRANCE

You can request more information about this medication by contacting the local representative of the Marketing Authorization Holder:

Curium Pharma Spain, S.A. Avda. Dr. Severo Ochoa, 29

28100-Alcobendas

Phone: 91 4841989

This leaflet was last revised in June 2020

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

The following information is intended only for healthcare professionals:

The complete technical data sheet for Erbium Citrate (169Er) Colloidal CIS bio international is included as a separate document in the product packaging to provide healthcare professionals with additional scientific and practical information on the administration and use of this radiopharmaceutical.

Please consult the Technical Data Sheet.

Online doctors for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

Discuss questions about ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Doctor

Hocine Lokchiri

General medicine 21 years exp.

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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€58
5.0 (3)
Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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€80
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Doctor

Lina Travkina

Family medicine 13 years exp.

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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€70
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Doctor

Alina Tsurkan

Family medicine 13 years exp.

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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€55
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Doctor

Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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€50

Frequently Asked Questions

Is a prescription required for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION?
ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION?
The active ingredient in ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION is erbium (169Er) citrate colloid. This information helps identify medicines with the same composition but different brand names.
Who manufactures ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION?
ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION is manufactured by Cis Bio International. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION?
Other medicines with the same active substance (erbium (169Er) citrate colloid) include Rhenium Sulfide (186Re) Colloidal CIS BIO INTERNATIONAL 148-370 MBq/mL Injectable Suspension, Yttrium Citrate (90 Y) Colloidal CIS BIO INTERNATIONAL 37-370 MBq/ml Injectable Suspension, SODIUM IODIDE (I131) CURIUM PHARMA SPAIN 37-7400 MBq CAPSULES. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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