Strontium-89 Chloride injection

What is strontium-89 injection?

STRONTIUM-89 (Metastron®) is a radioactive compound that treats pain caused by cancer that has spread to the bone. Strontium-89 concentrates in the area of bone metastasis or cancer. Generic strontium-89 injections are available.

What should my health care professional know before I use strontium-89?

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

• blood disorders

• kidney or bladder problems

• low platelet or white blood cell counts

• recent chemotherapy or radiation therapy

• an unusual or allergic reaction to strontium-89, nuclear medicine bone scan drugs, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

How should I use this medicine?

Strontium-89 is for injection into a vein. It is usually administered by a specially trained healthcare professional in an outpatient setting.

What if I miss a dose?

This does not apply.

What drug(s) may interact with strontium-89?

• chemotherapy

• radiation therapy

Talk to your prescriber or health care professional before taking any of these over-the-counter medicines:

• aspirin

• ibuprofen

• ketoprofen

• naproxen

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 strontium-89?

You must visit you prescriber or health care professional regularly for periodic blood tests to monitor your condition and the effects of strontium-89 treatment. If your pain increases or returns, contact your prescriber or health care professional.

The effects of strontium-89 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 strontium-89.

For several days after the injection, strontium-89 will be present your urine. To help protect you and others, certain steps need to be taken for week 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.

Within 2—3 days of your injection, you may feel a slight increase in pain, chills or fever that may last for 2—3 days. You should begin to notice a decrease in your pain within 2 weeks. This should continue and last up to 6 months. Depending upon your response, you may be able to decrease the amount of other pain medicines you are taking. Do not stop taking any medication without consulting with your prescriber or health care professional.

Strontium-89 may cause a slight decrease in your platelet and white blood cells. These should return to normal 6—8 weeks after your injection. Notify your prescriber or health care professional if you notice increased bruising, bleeding or blood in your urine or stools.

Unless instructed to by your prescriber or health care professional, avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), naproxen (Aleve®), or ketoprofen (Orudis® KT) products as these may mask a fever or increase your risk to bleed if you have low white blood cell or platelet counts.

You should use an effective method of birth control and avoid breast-feeding while receiving this drug.

You should tell any other health care professional providing you with medical care that you have received treatment with strontium-89.

What side effects may I notice from using strontium-89?

The side effects you may experience with strontium-89 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

• low blood counts - strontium-89 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):

• chills

• flushing

• pain flare

Where can I keep my medicine?

You will not be given injections of strontium-89 to keep at home.