Samarium Sm 153 Lexidronam – Intravenous Route

Samarium Sm 153 is part of a family of drugs called radiopharmaceuticals, which work by acting on one area of the body at a time to relieve pain.

Overview

Samarium Sm 153 Lexidronam is a drug that is used to study the functionality of various organs within the body. It is part of a family of drugs called the radiopharmaceuticals and is also prescribed to relieve pain in the bones caused by certain types of cancer, as well as other diseases.

Radiopharmaceutical drugs are radioactive agents that work by addressing each area for treatment at a time, preventing pain in that area. This treatment, given by injection into the affected area, can help to diagnose and treat certain conditions in various parts of the body. It can also relieve constant pain, particularly when used alongside other methods of palliative care.

There are certain types of cancer that can cause severe pain in the bones, in various parts of the body. Prostate cancer is a common cause of bone pain, along with bone cancer itself. Pain could become more severe as the cancerous tumor grows. The pain is characterized by a dull aching or deep aching sensation, it is particularly common in the back, pelvis, legs, arms, and ribs. Pain is one of the main symptoms that a person could be suffering with from bone cancer. The pain may start as just a mild irritation, happening only at certain times of day (typically night time or when the affected bone is in use). The pain will gradually become constant until it will not go away (known as secondary bone cancer).

Samarium Sm 153 Lexidronam is also sold and marketed under its brand name Quadramet in the United States.

Conditions Treated

  • Bone pain caused by cancers such as prostate cancer and bone cancer

Type of Medication

  • Solution, to be administered as an injection

Side Effects

Samarium Sm 153 Lexidronam contains a radioactive medication, so the body is likely to experience some side effects while undergoing treatment, particularly at the start of the treatment course when the body is still adapting to the substance. There are some side effects that are very common in patients taking this injection, so are not normally cause for concern unless they persist or the patient catches an infection. There may be other drugs available to help mediate some of the side effects of this medication.

Common side effects include the below:

  • Diarrhea
  • Nausea and vomiting
  • Pain in the abdomen
  • Bone flare (bone pain may temporarily get worse before the pain subsides)
  • Dizziness or light-headedness
  • Fever or chills
  • Cough, wheezing or difficulty breathing
  • Skin rash
  • Pain in the chest
  • Pneumonia
  • Spinal cord compression
  • Pathologic fracture
  • Bronchitis
  • Hypertension
  • Hypotension
  • Coagulation
  • Hematologic and lymphatic interferences
  • Leukopenia

Patients are not likely to experience all of these adverse reactions, however, they are likely to experience at least one.

A recent medical study found that 83 percent of patients that took this drug experienced at least one adverse side effect. A total of 472 people with a form of cancer were monitored who took a course of the treatment. In this group, there were also 46 adverse serious side effects and 23 deaths. The serious side effects took place around 46 days on average after taking the treatment course of the drug, and the deaths took place after an average of 67 days.

The study found that the deaths and the adverse side effects were likely to have happened as a result of the underlying cancer, rather than as a direct effect of the medication being taken. However, the relationship between the medication, the disease and the marrow invasion by cancer cells is still unestablished. The conclusion, therefore, being that there is a small chance that the drug can contribute towards these serious adverse effects.

Dosage

Patients will be prescribed a dosage of Samarium Sm 153 Lexidronam that is dependent on their body weight.

The recommended dosage of Samarium Sm 153 Lexidronam is 1.0 mCi / kg of body weight.

In order to administer the medication to the patient, the doctor will first dilute the solution. Then that solution will be administered intravenously over a one minute period using an in-dwelling catheter. Each application will then be followed by a saline flush.

Patients should be carefully monitored throughout the treatment cycle, but should also take extra personal care to minimize the risk of picking up an infection. Patients should stay away from crowds, or other people that may have an infection, and should take extra care during personal hygiene regimes, for example, washing the hands regularly, using an anti-bacterial hand gel, using a soft toothbrush to prevent gum bleeding, and using an electronic razor when shaving to reduce the risk of cuts.

Interactions

There are some drugs that should not be used together at all, as they can create a severe interaction in the body. This interaction can come in the form of more severe side effects, or can lead to other conditions developing. You should always tell your doctor about any other medication that you are taking. If you are taking any of the below medications, you may not be suitable for taking Samarium Sm 153 Lexidronam; combining these drugs together could be very dangerous, so an alternative treatment may be recommended. Alternatively, you may need to come off your other medication before you start a treatment course of Samarium Sm 153 Lexidronam.

Major drug interactions with Samarium Sm 153 Lexidronam are:

  • Abemaciclib
  • Acalabrutinib
  • Aldesleukin
  • Alemtuzumab
  • Altretamine
  • Axicabtagene ciloleucel
  • Azacitidine
  • Azathioprine
  • Belinostat
  • Bendamustine
  • Bevacizumab
  • Bexarotene
  • Bleomycin
  • Blinatumomab
  • Bortezomib
  • Bosutinib
  • Brentuximab
  • Busulfan
  • Cabazitaxel
  • Capecitabine
  • Carboplatin
  • Carfilzomib
  • Carmustine
  • Chlorambucil
  • Cisplatin
  • Cladribine
  • Clofarabine
  • Clozapine
  • Cobimetinib
  • Copanlisib
  • Cyclophosphamide
  • Cytarabine
  • Cytarabine liposomal / Daunorubicin liposomal
  • Cacarbazine
  • Dactinomycin
  • Daratumumab
  • Dasatinib
  • Daunorubicin
  • Daunorubicin liposomal
  • Decitabine
  • Docetaxel
  • Doxorubicin
  • Doxorubicin liposomal
  • Elotuzumab
  • Epirubicin
  • Eribulin
  • Etoposide
  • Floxuridine
  • Fludarabine
  • Fluorouracil
  • Gemcitabine
  • Gemtuzumab
  • Hyaluronidase / Rituximab
  • Hydroxyurea
  • Ibritumomab
  • Ibrutinib
  • Idarubicin
  • Idelalisib
  • Ifosfamide
  • Ifosfamide / Mesna
  • Imatinib
  • Inotuzumab ozogamicin
  • Interferon alfa-2a
  • Interferon alfa-2b
  • Interferon alfa-2b / ribavirin
  • Interferon alfa-n1
  • Interferon alfacon-1
  • Interferon gamma-1b
  • Iodine i 131 tositumomab
  • Irinotecan
  • Irinotecan liposomal
  • Ixabepilone
  • Ixazomib
  • Lenalidomide
  • Letrozole / ribociclib
  • Levamisole
  • Lomustine
  • Mechlorethamine
  • Melphalan
  • Mercaptopurine
  • Methotrexate
  • Midostaurin
  • Mitomycin
  • Mitoxantrone
  • Nelarabine
  • Nilotinib
  • Niraparib
  • Obinutuzumab
  • Ofatumumab
  • Olaparib
  • Omacetaxine
  • Osimertinib
  • Oxaliplatin
  • Paclitaxel
  • Paclitaxel protein-bound
  • Palbociclib
  • Panobinostat
  • Pazopanib
  • Peginterferon alfa-2a
  • Peginterferon alfa-2b
  • Pemetrexed
  • Pentostatin
  • Plicamycin
  • Pomalidomide
  • Ponatinib
  • Pralatrexate
  • Procarbazine
  • Ribociclib
  • Rituximab
  • Romidepsin
  • Ruxolitinib
  • Streptozocin
  • Temozolomide
  • Teniposide
  • Thalidomide
  • Thioguanine
  • Thiotepa
  • Tipiracil / trifluridine
  • Tisagenlecleucel
  • Topotecan
  • Tositumomab
  • Trabectedin
  • Trastuzumab
  • Trimetrexate
  • Uracil mustard
  • Venetoclax
  • Vinblastine
  • Vincristine
  • Vincristine liposome
  • Vinorelbine
  • Ziv-aflibercept

Warnings

There are several health warnings to be aware of before taking this medication.

Children

There is no information on the impact of Samarium Sm 153 Lexidronam on children, as studies on this drug have only been carried out in adult patients. The medication is not normally used in children, a medical professional should proceed with caution in this area. If administered to a child, that child should remain under close supervision throughout the treatment cycle.

Geriatric

There have been various studies that have found this drug to be very effective at reducing bone pain in geriatric patients. However, older patients have an increased likelihood of suffering from side effects or other health problems that could be serious. Older patients should take extra care to report any unusual side effects and take extra measures to ensure that they do not pick up infections.

Pregnancy and breastfeeding

Samarium Sm 153 Lexidronam has been classed as a category D drug for use during pregnancy. This means that, although there is no proof on humans available, the drug has the potential to cause harm to a fetus. The risks and the benefits should be outweighed before administering this medication to a pregnant woman. Women should take a pregnancy test before administration. You should also not attempt to conceive a child while taking this medication (both men and women).

It is also unknown whether Samarium Sm 153 Lexidronam can pass into the breast milk, so nursing mothers should proceed with caution, or another drug may be recommended.

Storage

The solution for Samarium sm 153 lexidronam should be kept at room temperature at all times (between 15 and 30 degrees centigrade), although the ideal temperature is 25 degrees.

Once the solution is diluted, it needs to be administered immediately. The solution can be kept for up to four hours if it is refrigerated.

Do not use the solution after this time otherwise the substance may not be as effective or may be harmful to the patient.

Summary

Samarium Sm 153 Lexidronam has been found by many medical studies and records to be a very effective medication for easing bone pain in patients with various forms of cancer – most commonly prostate cancer and bone cancer. It is therefore widely used in patients of all adult age groups with high success rates.

The drug should only be administered by an experienced healthcare professional and, due to the risks of infections and side effects, patients should be closely monitored throughout the course of treatment to minimize any health risks. The drug is a relatively safe pain relief option, provided all administration and personal care instructions are adhered to; however, it should be avoided during pregnancy and breastfeeding. There have been medical studies that have detected deaths and adverse side effects in those that have taken Samarium Sm 153 Lexidronam; however, it is not known whether those deaths and adverse reactions are as a result of taking the drug, or whether they were down to the underlying conditions.

Doctors should fully explain to patients the risks involved with taking this medication, and patients should make sure they understand any possible consequences before starting a course. They should also have a full discussion about their health and medical needs with their doctor before taking Samarium Sm 153 Lexidronam.

Samarium Sm 153 Lexidronam may not be suitable for everyone; those that are on some life-saving cancer treatments may need to take an alternative painkilling medication as this one can react with several drugs.

 

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Last Reviewed:
January 30, 2018
Last Updated:
January 27, 2018