Nuclear Pharmacy

What is Nuclear Pharmacy?

First specialty practice of Pharmacy established by the Board of Pharmacy Specialties in 1978 Nuclear pharmacists prepare and dispense patient-specific radiopharmaceutical doses for diagnostic imaging and therapeutic procedures for use in hospital nuclear medicine departments and outpatient clinics

What is a radiopharmaceutical?

A compound that incorporates a radioactive atom into a biologically-active molecule which localizes in a physiological or pathophysiological system Doses are measured in units of radioactivity termed curie (Ci) or becquerel (Bq) The physical half-life of radiopharmaceuticals is the time for one-half of the radioactivity to decay, which is usually only a few hours The short physical half-life of most radiopharmaceuticals requires preparation close to the time of use In diagnostic imaging, a radioactive atom, often attached to a ligand, travels to and localizes in a physiological process while emitting gamma and x-rays which are detected by a special camera providing assessment of function Diagnostic radiopharmaceuticals are specifically formulated to exert NO pharmacological effect and evaluate physical process Therapeutic radiopharmaceuticals emit beta- and alpha particles that are designed to target and kill specific cells, such as cancer

What’s different about Nuclear Pharmacy?

The majority of nuclear pharmacists practice in closed-door commercial settings, providing services to local hospitals and clinics They are also found within large medical centers, and are often involved in drug discovery and development research While direct patient contact is minimal, the nuclear pharmacist provides drug information to nuclear medicine technologists and physicians, indirectly contributing to the care of individual patients Radiopharmaceuticals are sold to hospitals or clinics authorized to receive radioactive material, so the nuclear pharmacy staff isn’t involved in cash sales or insurance reimbursement Nuclear pharmacists’ work begins as early as midnight to prepare and dispense the radiopharmaceuticals to be administered to patients same day Nuclear pharmacists must complete a program to qualify as an Authorized Nuclear Pharmacist (ANP) with specialized education and training to prepare sterile compounds, handle radioactive materials, prepare shipments of radioactive material, and comply with federal and state regulations governing the use, handling, distribution and disposal of radioactive material.

Nuclear Pharmacy Resources

APhA Publications

Radiopharmaceuticals in Nuclear Pharmacy and Nuclear Medicine: This book contains essential information required by state and federal radiation licensing organizations for specialty practitioners preparing to become authorized nuclear pharmacists or authorized nuclear medicine physicians.

Nuclear Pharmacy Quick Reference: Built on nearly 50 tables and figures, the handbook provides essential facts and information used daily in nuclear pharmacy practice.

Diagnostic Imaging for Pharmacists: This book provides pharmacists and student pharmacists with a basic understanding of diagnostic imaging and of pharmaceuticals used as a part of the imaging process.

Radiopharmaceutical Vendor Qualification Checklist: This is a tool for nuclear medicine and pharmacy departments to use to evaluate commercial nuclear pharmacy vendors.

APhA Annual Meeting and Exposition

The APhA Annual Meeting and Exposition typically offers approximately 15 hours of live continuing education geared toward the practice of nuclear pharmacy. Several of these sessions are also now approved for BCNP recertification credit. Learn more.

Additional References

Fundamentals of Nuclear Pharmacy, Sixth Edition.  Gopal B. Saha.  2010

Nuclear Pharmacy: Concepts and Applications.  Blaine Templar Smith.  2010

Nuclear Medicine, 2nd edition Robert Henkin 2006

Nuclear Medicine Technology Procedures and Quick Reference; Peter Shackett, 2000

Education and Certification Information /Licensure Links

Authorized Nuclear Pharmacist training requirements: Outlined by the Nuclear Regulatory Commission (NRC) in 10 CFR 35.55

Board Certified Nuclear Pharmacist eligibility requirements: Determined by the Board of Pharmacy Specialties (BPS)

Nuclear Education Online (NEO): NEO is an educational consortium between the University of Arkansas for Medical Sciences and the University of New Mexico College of Pharmacy. The program includes authorized user training for pharmacists and CPE activities.

Purdue University Nuclear Pharmacy Program: In addition to a nuclear pharmacy certificate program, Purdue offers continuing education activities that meet the requirements set forth by the Board of Pharmacy Specialties for recertification. Subscribers to the CE program are also given access to many reference materials and learning tools for nuclear pharmacy practitioners.

University of Tennessee Nuclear Pharmacist Program: The Memphis campus of the University of Tennessee College of Pharmacy offers a certificate program in nuclear pharmacy. Also, a continuing education program in nuclear pharmacy is offered to pharmacy graduates, and this program provides the didactic educational requirements for authorized user training for pharmacists.

Practice Tools, Standards, and Guidelines

Several professional organizations provide tools and publish detailed guidelines for the clinical applications of radiopharmaceuticals used in nuclear medicine:


Journal of the American College of Radiology: Provides information related to Health Services research & policy, clinical practice management, training & education.One of its featured tools, Radiation Dose Optimization in pediatric patients, can be located under the Resource Center tab.

Journal of Nuclear Cardiology: This is the official peer-reviewed publication of the American Society of Nuclear Cardiology (ASNC) devoted to publishing the newest research and clinical developments in the field. Also offers PET/SPECT resources and PUBMED search for nuclear cardiology study articles.

Journal of Nuclear Medicine: This is a peer-reviewed, monthly publication, offering readers around the globe clinical investigations articles, basic science reports, continuing education articles, and book reviews.

Journal of Nuclear Medicine Technology: This journal offers a portable database of ADR and DI with radiopharmaceuticals and is available at: with the installation of the Datinrad software. This open access app is free in both English and Spanish. Also has a Comprehensive Software Applications for performing calculations of doses under the Nucleolab program

Regulatory Information 

FDA guidance for positron emission tomography (PET) production facilities operating under CGMP criteria

Guidance for radiopharmaceutical compounding or production that is exempt from CGMP requirements: USP <823>, USP <797>, USP <1823>; requires subscription to USP

Coalition for Pet Drugs: Forum for PET drug manufacturing to address current topics with government agencies and other groups

NCI IND Regulatory & Manufacturing Resources: NIH-funded site providing various IND documents, templates and Investigator Brochures for numerous commonly used IND drugs.

Code of Federal Regulations (CFR) is the codification of the general and permanent rules and regulations (sometimes called administrative law) published in the Federal Register by the executive departments and agencies of the federal government of the United States. The CFR provides all federal laws for drugs, DOT, manufacturing, etc.

Nuclear Regulatory Commission (NRC) is an independent agency of the United States government tasked with protecting public health and safety related to nuclear energy.

Environmental Protection Agency (EPA) is an agency of the United States federal government whose mission is to protect human and environmental health.

Department of Transportation (DOT) is the department of the U.S. federal government that coordinates and institutes national transportation programs including transport of radioactive materials.

Radioactive Decay Calculators

The below sites are useful for determining radioactive decay calculations.

Sources for Procedure Dose Estimates

Radiology Journal - Effective Doses in Radiology and Diagnostic Nuclear Medicine

Radiology Info - Radiation Dose in X-Ray and CT Exams

Columbia University - Dose Estimates for Nuclear Medicine Scans

APhA-APPM Nuclear Pharmacy Practice Special Interest Group

Get involved and learn more about Nuclear Pharmacy Practice by joining the APhA-APPM Nuclear Pharmacy Practice Special Interest Group

APhA thanks Allegra DePietro, Richard Green, Charlotte Denise Jeffers, Lauren Kelbe, RC Riberich, and Garcia Simon-Clarke for their contributions to nuclear pharmacy practice content on