Xofigo Injection

Radiopharmaceutical for Pain Relief and Cancer control from Metastatic Bone Disease due to Prostate Cancer

Your doctor has recommended Xofigo® a radiopharmaceutical (RAY-dee-oh-far-muh-SUE-tuh-kol) 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.

Your radiopharmaceutical injection will be done as an outpatient procedure. The procedure will take approximately an hour.  You will be monitored for up to ½ hour after the injection after which you may go home.  You may continue your normal daily activities with friends and family members after your injection.

This radiopharmaceutical is routinely prescribed as a six (6) injection course, four (4) weeks apart to help with bone disease and improve survival.  Blood work will be required prior to each injection to ensure blood counts are stable. Your nurse will assist in coordinating the tests. A current weight will be required as well to help calculate your dose of medication. Continue taking your current pain medication. You and your doctor will decide if the dose needs to be adjusted.

Precautions

There are no restrictions regarding contact with other people after receiving Xofigo except as noted below.

For one week after each injection:

• Follow good hygiene practices in order to minimize radiation exposure to household members and caregivers from contact with contaminated bodily fluids.
• Patient should sit when urinating to avoid splashing, and flush the toilet twice after each use.
• 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.

For patients who are sexually active, use condoms and make sure female partners, who may become pregnant, use highly effective birth control methods during treatment and for six months after completion of Xofigo treatment.

Possible Side Effects

• 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.
• Nausea, vomiting and Diarrhea
• Swelling in your hands or feet
• Kidney failure and impairment

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 or from your nose
• 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 3 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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