Radiopharmaceuticals for Pain Relief from Metastatic Bone Disease

Your doctor has recommended radiopharmaceuticals (RAY-dee-oh-far-muh-SUE-tuh-kols) to treat your bone pain. 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.

Your radiopharmaceutical injection will be done as an outpatient procedure. The injection will take only a few minutes, after which you may go home. You may continue your normal daily activities with friends and family members after your injection. Pain relief usually occurs within seven to 10 days after the injection.

Relief may last from three to six months or more. Your doctor may repeat the injection every 90 days if your blood counts are stable. Continue taking your current pain medication. You and your doctor will decide if the dosage needs to be adjusted.  A bone scan must be done within 3 months of the  injection. 

Precautions

Because radiopharmaceuticals are removed by the kidneys through your urine, there are some precautions you will need to take:

• Before your injection, you will be asked to drink about two cups of fluid. For the first 24 hours after your injection, it is important to empty your bladder frequently.
• For the first 12 hours after your injection, it is important to use a toilet when possible, rather than a urinal or bedpan. Flush the toilet twice after each use.
• If urine is spilled, the area should be cleaned completely, and you must wash your hands with soap and water.
• Clothing stained with your blood or urine should be washed separately or stored separately for one to two weeks before washing with your regular load of laundry.
• If you are sexually active, it is strongly advised that you use an effective method of birth control for 30 days after your injection. Speak to your doctor or nurse if you have questions about birth control methods.

Possible Side Effects

Increased bone pain may occur for the first week following your injection. This pain is usually controlled with the pain medication that has been ordered by your doctor.

• A drop in your red blood cells and platelet counts may occur. Your doctor may monitor your blood counts weekly for up to three months after your injection. It is important to follow your doctor’s instructions for your blood work and to keep any follow-up appointments.  We will give you a prescription for regular blood counts to be drawn.

Things to Report to Your Nurse or Doctor

Tell your nurse or doctor if you have any of the following symptoms:

• Blood in your sputum (saliva), urine, or stool, or bleeding from your gums when brushing your teeth
• Loss of ability to have an erection (erectile dysfunction)
• Increased muscle weakness
• Trouble walking
• New onset of incontinence (loss of control of your bladder or bowel)
• Inability to urinate (empty your bladder)
• Loss of sensation (feeling) for temperature, light touch, or pressure on your feet, legs, or arms
• Any new or unusual symptoms

Things to Report Immediately

Call your nurse or doctor immediately if you have any of the following symptoms:

• Temperature of 100.5°F (38°C) or above
• Bleeding that you cannot stop after putting mild pressure on the site for three minutes
• Sudden, sharp, or new neck or back pain not relieved by your prescribed pain medication
• Inability to move your legs

In an Emergency Call:

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