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

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

Ask a doctor about a prescription for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

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Tarek Agami

General medicine11 years of experience

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine18 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

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

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.

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.

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 dosage, side effects, interactions, contraindications, and prescription renewal for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION – subject to medical assessment and local rules.

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Doctor

Tarek Agami

General medicine11 years of experience

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine18 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Duarte Meneses

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Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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Key areas of consultation:

  • Preventive and family medicine
  • Women’s health, including gynaecology and obstetrics
  • Chronic disease management: hypertension, diabetes, and more
  • Mental health support, anxiety, and counselling
  • Postoperative care and lab test interpretation
She has conducted research on the genetic background of stroke and is skilled in communicating with patients from diverse cultural backgrounds. Her approach combines clinical expertise with empathy and clear communication.
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His areas of focus include:

  • General and urgent care: fever, fatigue, infections, digestive issues, respiratory symptoms, and other common concerns
  • Chronic condition support: hypertension, high cholesterol, diabetes, thyroid issues
  • Aesthetic medicine and dermatology: acne, skin ageing, hyperpigmentation, personalised skincare guidance
  • Trichology: hair loss, scalp conditions, treatment strategies for men and women
  • Preventive care: health check-ups, lifestyle advice, second opinions

Dr. Correa combines medical knowledge with an aesthetic and holistic approach to help patients improve both health and quality of life.

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Anastasiia Shalko

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Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Tomasz Grzelewski

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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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Dr. Raevskii provides medical care in the following areas:

  • Diagnosis and management of common conditions: hypertension, diabetes, respiratory and digestive disorders.
  • Oncological consultations: early cancer detection, risk evaluation, and treatment navigation.
  • Supportive care for oncology patients – pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Antonio Cayatte

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Dr Antonio Cayatte is a physician in General and Acute Medicine with over 30 years of experience across clinical care, medical research, and education. He offers online consultations for adults with a wide range of symptoms, both acute and chronic.

His clinical background includes:

  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad
Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association.

Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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Lina Travkina

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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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