Radium 223 Dichloride

What is Radium 223 Dichloride

Radium 223 dichloride is a radiopharmaceutical agent which, in combination with best standard of care (including androgen deprivation therapy), was shown to improve overall survival and time to first symptomatic skeletal event compared to placebo and best standard of care in patients with castration-resistant prostate cancer and symptomatic bone metastases without known visceral disease.

Most of the energy from radium-223 is emitted as alpha-particles (95.3%), with a much smaller percentage as beta-particles (3.6%) and gamma-radiation (1.1%).

Gamma-radiation allows for the measurement of radioactivity and detection of contamination with standard instruments. The specific activity of radium-223 is 1.9 MBq/ng (51.4 microcurie/ng), with typical treatment activity below 8,000 kBq (216 microcurie).

Unlike gamma-radiation (blocked by lead or concrete) and beta-particles (blocked by aluminum), alpha-particles are unable to penetrate skin or paper; therefore, the radiation exposure associated with handling of patient doses is expected to be low. R

adium-223 dichloride is FDA-approved for the treatment of castration-resistant prostate cancer in patients with symptomatic bone metastases and no known visceral metastases.

Brand Name

Xofigo

Indications & Dosage

  • prostate cancer

For the treatment of castration-resistant prostate cancer, in patients with symptomatic bone metastases and no known visceral metastatic disease

Side Effects

  1. anemia
  2. dehydration
  3. diarrhea
  4. erythema
  5. infection
  6. injection site reaction
  7. leukopenia
  8. nausea
  9. neutropenia
  10. new primary malignancy
  11. pancytopenia
  12. peripheral edema
  13. thrombocytopenia
  14. vomiting

Monitoring Parameters

  • CBC with differential
  • pregnancy testing

Contraindications

  • accidental exposure
  • anemia
  • bone marrow suppression
  • breast-feeding
  • chemotherapy
  • children
  • contraception requirements
  • females
  • infants
  • infertility
  • male-mediated teratogenicity
  • neonates
  • neutropenia
  • pregnancy
  • reproductive risk
  • thrombocytopenia

Interactions

  • Abiraterone
  • Clozapine
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