Radium Ra 223 dichloride (Xofigo®)

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About This Drug

Radium Ra 223 dichloride is a radiopharmaceutical to treat your bone pain, improve cancer control and decrease skeletal complications. A radiopharmaceutical is a radioactive drug that is given through an injection in your arm. Once injected, the medication travels through your body and settles in your bones, giving you relief from pain.

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Nausea and throwing up (vomiting)
  • Loose bowel movements (diarrhea)
  • Swelling of your legs, ankles and/or feet

Note: Each of the side effects above was reported in 10% or greater of patients treated with radium ra 223 dichloride. Not all possible side effects are included above.

Warnings and Precautions

  • Severe bone marrow depression

Important Information

  • Clothing soiled with patient urine, blood, or fecal matter should be washed promptly and separately from other clothing. Household members and caregivers should use rubber gloves when handling bodily fluids to avoid contamination.
  • While the amount of radiation exposure potential from the patient is minimal, close or prolonged contact with pregnant women or young children should be avoided.
  • It is important that you follow good hygiene practices during treatment and for 1 week after treatment to minimize radiation exposure from your bodily fluids to others.
  • Stay well hydrated during your treatment.
  • Patient should sit when urinating to avoid splashing. It is also recommended that you flush your toilets several time after each use and wash your hands after using the bathroom. Your caretakers should not handle your urine or any other bodily fluids with bare hands and should wear latex gloves.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.

Food and Drug Interactions

  • There are no known interactions of radium Ra 223 dichloride with food, or other medications.
  • Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Weight gain of 5 pounds in one week (fluid retention)
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. This drug should not be used by women of childbearing potential or pregnant women. Men with female partners of childbearing potential should use a condom during your cancer treatment and for at least 6 months after your cancer treatment and their female partners of childbearing potential should use highly effective methods of birth control during and for 6 months after treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised March 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.