Radium Ra 223 Dichloride Intravenous Route

Radium Ra 223 Dichloride is an injected medication also sold under the trade name Xofigo, used on men who have been diagnosed with prostate cancer which has metastasized into the bones but not the internal organs.

Overview

What is Radium Ra 223 Dichloride?

Radium Ra 223 Dichloride is a radiopharmaceutical drug; a radioactive substance that is used to treat mCRPC, a condition known as metastatic castration-resistant prostate cancer. Men who are diagnosed with mCRPC have a form of prostate cancer that has spread to their bones but nowhere else in their bodies, such as internal organs. These patients receive Radium Ra 223 Dichloride as an intravenous injection once every four weeks for a total of six doses by a radiation therapy specialist.

How does Radium Ra 223 Dichloride work?

Radium Ra 223 Dichloride is a radioactive drug that mimics calcium and fuses with the bones in the body at the site of the cancer. The drug then gives out alpha particles, which destroy the DNA of the cancer cells found nearby, which causes them to die. As this drug can be directly aimed at the cancer cells, it does limited damage to the surrounding healthy bone and tissue.

Conditions treated

  • Metastatic castration-resistant prostate cancer, mCRPC

Type of medicine

  • Radiopharmaceutical

Side effects

By bonding with cancer cells and affecting their DNA and the process by which they divide, Radium Ra 223 Dichloride may also cause unwanted effects that could range from annoying to severe. During radiotherapy with Radium Ra 223 Dichloride, you will be closely monitored by a team of specialists, including blood work and the function of your vital organs to make sure no long-term health damage is resulting from the use of this drug. Radium Ra 223 Dichloride will expose you to radiation; caution should be taken to avoid exposing caregivers and loved ones to your bodily fluids during this time. Your cancer care specialist team can advise you on ways to protect those around you from radiation exposure during your treatment.

If the following unwanted health issues appear after treatment with Radium Ra 223 Dichloride, check with your cancer treatment team immediately:

  • Stools appear black or tar-like
  • Gums that bleed
  •  Swollen, bloated arms, lower legs, feet, hands or face
  • Urine or stools with signs of blood
  • Pains in chest
  • Cough
  • Chills
  • Fever
  • Pain in side or lower back
  • Urination is difficult or painful
  • Urination is less often or lower in quantity
  • Skin is pale
  • Skin has tiny red dots
  • Gaining weight rapidly
  • Breathing is difficult
  • Throat is sore
  • Ulcers, spots or sores in the mouth or lips
  • Glands swollen
  • Feet or hands tingle
  • Labored breathing after activity
  • Bruises or bleeding unexpectedly
  • Fatigue
  • Weak muscles
  • Dizzy, lightheaded
  • Confusion
  • Mouth is dry causing thirst
  • Fainting
  • Elevated temperature
  • Hoarse voice
  • Rapid heartbeat
  • Hypertension
  • Appetite loss
  • Nausea
  • Shallow or labored breathing
  • Eyes appear sunken
  • Vomiting
  • Skin appears wrinkled

During treatment Radium Ra 223 Dichloride may give you the following ill symptoms, which are typically relieved after treatment is complete. For more information on how to ease or eliminate these symptoms, check with your cancer treatment staff and report any signs such as:

  • Red, painful swollen injection site
  • Diarrhea

If your body temperature is elevated and/or you have chills, you may have an infection requiring immediate attention by medical personnel. Vomiting, diarrhea, nausea, bruising or bleeding that is unusual, stools with signs of blood or fatigue to the extreme should be reported within 24 hours to your cancer care specialist team.

Dosage

Patients receive Radium Ra 223 Dichloride as an intravenous injection once every four weeks for a total of six doses by a radiation therapy specialist in a hospital or professional medical setting. Each patient has different requirements based on age, physical stature, overall health and much more information. Therefore, this dosage information is given as general, baseline information only. Your team of cancer treatment health care professionals will determine your dosage and course of treatment.

Typically, patients are given 1.35 microcurie per kilogram of body weight of Radium Ra 223 Dichloride as an intravenous injection, with a dosing schedule of once every four weeks for a total of six doses. During this course of treatment, patients should expect to have regular testing for levels of white blood cells as well as levels of blood platelets to make sure they are healthy enough to continue treatment.

Interactions

Radium Ra 223 Dichloride will most likely be combined with other drugs in order to attack your cancer effectively. You may also receive other drugs to prevent unwanted symptoms or for other health reasons. All of your medications will be determined by your team of cancer treatment professionals, however, it is of great importance to disclose to this team all of the medications you are currently taking, including over-the-counter and prescription drugs as well as holistic or vitamin supplements.

Check with your team of cancer care specialists for any warnings or concerns with regard to certain foods, use of tobacco and consumption of alcohol.

Being diagnosed with other diseases may affect the way you are prescribed treatment with Radium Ra 223 Dichloride. This drug may also exacerbate the symptoms or worsen the disease, depending on the nature of your health. Alert your physician if you have been diagnosed with:

  • Low count of white blood cells (Leukopenia)
  • Bone marrow disease
  • Low blood platelets Thrombocytopenia

Warnings

Any unusual reaction you’ve experienced during treatment with other drugs or allergies to preservatives, colorings, foods, animals or environments should be discussed with your cancer treatment team prior to your drug therapy with Radium Ra 223 Dichloride.

No studies have provided sufficient data with regard for increased risks or diminished effectiveness of Radium Ra 223 Dichloride in use in pediatric patients. The side effects, warnings and precautions for this age group are the same as for adult patients.

Similarly, older patients have not been the subject of particular studies with recommendation for treatment with Radium Ra 223 Dichloride, so expect the same side effects and methods of treatment as other patients.

There is a significant risk to fetal well-being and, therefore, women who are pregnant should not be treated with Radium Ra 223 Dichloride. Men under treatment with Radium Ra 223 Dichloride have caused birth defects when they fathered children during their therapy. Your cancer care team will most likely advise you to use a reliable form of birth control during treatment with Radium Ra 223 Dichloride to avoid becoming pregnant or getting your partner pregnant during treatment and for at least six months post-treatment.

Breastfeeding women should not be treated with Radium Ra 223 Dichloride, as it has proven to be harmful to infants when passed through breast milk. Alternative treatment should be used or breastfeeding should be halted when treatment begins.

As your white blood cell count will decrease while being treated with Radium Ra 223 Dichloride, you are prone to infections. The platelets in your blood will also be at a low level, decreasing the ability of your blood to clot properly. For this reason, it is advised that you:

  • Avoid persons with colds or infections
  • Alert your physician to unusual bleeding, bruising, skin spots, tar-like stools or blood in urine
  • Practice dental hygiene with caution, using soft bristle brushes and other methods of cleaning
  • Avoid dental work if possible
  • Keep hands away from nose and eyes unless just washed
  • Use caution when shaving or trimming nails
  • Eliminate participation in sports or other bruise-prone activities

Any signs of confusion, a decrease in your urine amount or frequency, dizziness, cotton mouth, rapid heartbeat, fainting, being light headed, fatigue, muscle weakness, panting for breath or eyes that are sunken should be reported to your cancer treatment team right away as you could be dehydrated.

Blood in your urine or a smaller amount of urine than normal, swollen fingers, face, lower legs, trouble breathing or weight gain could be signs of kidney damage. Contact your physician immediately if you have these symptoms.

Patients under treatment with Radium Ra 223 Dichloride should not have chemotherapy simultaneously with this drug, as the activity in the bone marrow could decrease to dangerous levels.

Radium Ra 223 Dichloride will expose you to radiation; prevent your body fluids from exposing family members to this radiation while you are under treatment. Stay well hydrated, get a restful night’s sleep, and practice good nutrition, using the anti-nausea medication your cancer specialists have prescribed for you. Avoid alcoholic beverages if possible or keep them to a minimum. Side effects should be reported to your cancer treatment team as soon as possible so that care and attention can be given to ease your symptoms and prevent long-term health implications.

Make sure that you keep all appointments with your cancer care physician so that your blood cell levels can be monitored for any unwanted changes.

Storage

As Radium Ra 223 Dichloride is a medication that is given only during treatment of cancer in a hospital setting by trained professionals, storage is instructed directly to this staff by the manufacturer of the drug.

Summary

Radium RA 223 Dichloride is an injected radiopharmaceutical drug used to treat men who have been diagnosed mCRPC or metastatic castration-resistant prostate cancer. This is a cancer of the prostate gland that has spread to the bones but nowhere else in the body. Radium Ra 223 Dichloride works by taking on the characteristics of calcium, enabling it to bond with the cancer cells in the bones, interrupting their DNA life cycle and killing them to prevent the spread of the disease.

Radium Ra 223 Dichloride is injected intravenously in a hospital or medical center setting with the dose depending on the patient’s details such as physical stature and overall health. The course of treatment includes one injection every four weeks for a total of six treatments.

Typical side effects of Radium Ra 223 Dichloride include nausea, diarrhea, vomiting, peripheral (hands, lower legs) edema (swelling), low counts of both white cells and platelets in the blood, dehydration, pain at the site of the injection and kidney issues. Any symptoms like this should be reported to your team of cancer treatment professionals immediately. Expect to fulfill regular appointments for blood count testing during your phase of treatment.

Patients are advised to avoid becoming pregnant or getting their partners pregnant while being treated with Radium Ra 223 Dichloride and to stop breastfeeding during this time.

 

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Last Reviewed:
January 30, 2018
Last Updated:
February 10, 2018
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