Pharmacology. Insoluble Prussian blue (ferric hexacyanoferrate) has been used to treat radioactive and nonradioactive cesium and thallium poisonings. Owing to the long half-lives of these isotopes, ingestion can pose significant long-term health risks. Insoluble Prussian blue binds thallium and cesium in the gut as they undergo enterohepatic recirculation, enhancing fecal excretion. Proposed mechanisms of binding include chemical cation exchange, physical adsorption, and mechanical trapping within the crystal lattice structure. Insoluble Prussian blue is not absorbed across the intact GI wall.

Indications. Known or suspected internal contamination by:

1. 
   

   Radioactive cesium (eg, 137Cs) and nonradioactive cesium.

   
   
2. 
   

   Radioactive thallium (eg,201Tl) and nonradioactive thallium.

Contraindications.

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