Samarium-153 Lexidronam injection

What is samarium-153 injection?

SAMARIUM-153 LEXIDRONAM (Quadramet®) treats pain caused by cancer that has spread to the bone. It goes to the source of cancer bone pain and may alleviate the pain associated with these cancers. Generic samarium-153 injections are not available.

What should my health care professional know before I use samarium-153?

They need to know if you have any of these conditions:

• blood disorders

• heart, kidney, or bladder problems

• infection (bacterial, viral, or fungal)

• recent chemotherapy or radiation therapy

• an unusual or allergic reaction to samarium-153, nuclear medicine bone scan drugs, other phosphonate drugs, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Samarium-153 lexidronam is for injection into a vein. It is usually administered by a healthcare professional in an outpatient setting. At the time you receive your medicine, you will need to drink about 2 cups of fluid.

What if I miss a dose?

This does not apply.

What drug(s) may interact with samarium-153?

• chemotherapy

• radiation therapy

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking samarium-153?

You must visit you prescriber or health care professional regularly for periodic blood tests to monitor your condition and the effects of samarium-153 treatment.

The effects of Quadramet® are limited to within your own body. Other people will not be harmed by coming into contact with you. You may eat and drink normally after receiving Quadramet®.

In the first few hours after getting your injection, urinate as frequently as possible. For several hours after the injection, Quadramet® will be in your urine. To help protect yourself and others, certain steps need to be taken for 12 hours after receiving the injection. Whenever possible, use a toilet rather than a urinal, and flush several times after each use. Any spilled urine should be cleaned up completely, and you should wash your hands thoroughly. If any blood or urine gets onto your clothing, wash those clothes separately or store them for one to two weeks.

You should use an effective method of birth control while receiving this drug.

You should tell any other health care professional providing you with medical care that you have received treatment with Quadramet®.

What side effects may I notice from using samarium-153?

The side effects you may experience with samarium-153 therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:

• chest pain

• difficulty breathing, wheezing

• numbness, tingling, pain or weakness in the hands or feet

• skin rash, hives, or itching

• swelling of the lips, tongue or face

• low blood counts - samarium-153 may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.

• signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine

• signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine

• signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• cough

• diarrhea

• dizziness

• flushing

• nausea

• stomach pain

Where can I keep my medicine?

You will not be given injections of Quadramet® to keep at home.