prussian blue

Action and Spectrum

Mechanism of action 

The primary mechanism of action is its ability to bind specific metal ions, such as cesium and thallium, in the gut and prevent them from being absorbed into the body. This property sounds like an oral treatment for individuals who have ingested these radioactive materials. 

In addition to its binding properties, prussian blue also has other actions, such as the ability to act as an antioxidant. This is due to the iron ions in the compound, which can act as catalysts in various chemical reactions, and the cyanide groups, which can scavenge free radicals.  

Spectrum 

The spectrum of prussian blue refers to the range of chemical and physical properties that the compound exhibits. Some of the critical properties of Prussian blue that are relevant to its medical and industrial applications include: 

• Metal binding: As mentioned earlier, Prussian blue can bind specific metal ions, such as cesium and thallium, in the gut and prevent them from being absorbed into the body. This property is essential in treating individuals who have ingested radioactive materials. 
• Antioxidant activity: The iron ions in Prussian blue can act as catalysts in various chemical reactions, and the cyanide groups can scavenge free radicals. This property gives the compound antioxidant activity, which can be helpful medical applications. 
• Pigment properties: It is also used in various industrial applications, such as in the production of paint, ink, and dye. 
• Heavy metal removal: It can remove heavy metals from wastewater. It can also be used as a detoxifying agent for heavy metal poisoning 

Drug Interaction

Adverse Reaction

Frequency defined:  

>10% 

Constipation 

1-10% 

Asymptomatic hypokalemia 

Black Box Warning

Contraindication / Caution

Contraindications 

None 

Caution 

Decreased gastrointestinal motility, or slow movement of food through the digestive system, is a potential side effect of prussian blue treatment, especially if a patient has also received a high radiation-absorbed dose to the gastrointestinal mucosa. This side effect can lead to constipation, which can be monitored and treated as necessary. 

It’s also essential to monitor serum electrolyte levels, especially potassium and phosphorus, during treatment with prussian blue. The compound can cause electrolyte imbalances, which can have serious health consequences if left untreated. 

Another potential side effect of the prussian blue treatment is blue discoloration of the stool, oral mucosa, and dentition. This discoloration is due to the blue color of the compound and is not harmful, but it can be distressing to some patients

Pregnancy / Lactation

Pregnancy consideration: C 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology 

When taken orally, prussian blue is rapidly absorbed from the gut and distributed throughout the body. The compound is a complex chemical that contains both iron and cyanide groups. 

One of the prussian blue’s primary mechanisms of action is its ability to bind specific metal ions, such as cesium and thallium, in the gut and prevent them from being absorbed into the body. This is achieved through its high binding affinity for these metal ions and ability to form stable, insoluble complexes. 

Pharmacodynamics 

The main pharmacodynamic effect is binding specific metal ions, such as cesium and thallium, in the gut and preventing them from being absorbed into the body. This is achieved through the high binding affinity of these metal ions to the iron and cyanide groups within the compound, which forms stable, insoluble complexes. 

Pharmacokinetics 

Absorption 

prussian blue, when taken orally, is not well absorbed by the body 

Distribution 

prussian blue, when taken orally, is not well absorbed into the bloodstream. It binds with radioactive cesium or thallium ions in the gut and forms insoluble complexes which are eliminated through the feces. Since the compound is not well absorbed into the bloodstream, it does not have a wide distribution throughout the body. 

Metabolism 

prussian blue is not metabolized by the body, meaning that it does not undergo any chemical changes that would alter its chemical structure. 

When taken orally, prussian blue is rapidly absorbed from the gut. Still, it is not well absorbed into the bloodstream, and most of the compound is eliminated unchanged through the feces. This means that there is no significant metabolism of the compound in the body. 

Elimination/excretion 

Most of the compound is excreted unchanged in the feces, with less than 1% being eliminated in the urine. This means that the compound does not reach the bloodstream in significant amounts and does not have systemic effects. 

Because of this characteristic, its efficacy is limited to the gut and has no systemic effects. The compound’s action is confined to the gut, which binds with the ingested radioactive materials and prevents their absorption into the body. It is then eliminated through the feces, preventing the radioactive materials from entering the bloodstream. 

Adminstartion

Administration 

prussian blue is administered orally, usually as a capsule or tablet. The typical dosage for treating radioactive cesium or thallium poisoning is around 15 to 20 grams daily, divided into three or four doses, taken with water, followed by a meal or a glass of milk. The treatment may continue for several days or weeks, depending on the amount of radioactive material ingested and the patient’s condition. 

It’s important to note that the dosage and duration of treatment with Prussian blue may vary depending on the individual patient’s needs and circumstances, such as their age, overall health, and the severity of their condition. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: prussian blue 

Pronounced: [ PRUSH-an-BLOO] 

Why do we use prussian blue? 

prussian blue is a chemical compound with a wide range of uses in the medical and industrial fields. Some of the critical uses of include: 

• Treatment of radioactive cesium and thallium poisoning: One of the primary uses of Prussian blue is an oral treatment for individuals who have ingested radioactive cesium or thallium. The compound binds with these metal ions in the gut, preventing them from being absorbed into the bloodstream and then eliminated through the feces. 
• Industrial pigment: Prussian blue is used in various industrial applications, such as in the production of paint, ink, and dye. Its excellent lightfastness and tinting strength make it a popular choice in many industries. 
• Heavy metal removal: Prussian blue is also used to remove heavy metals from wastewater, such as lead and mercury. 
• Medical treatment for iron overload: Prussian blue has been used to treat certain iron overload disorders. One is hereditary hemochromatosis, a genetic disorder that causes excessive iron absorption from the diet. It is used to chelate or remove excess iron from the body.