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radium (223Ra) dichloride

V10XX03

Forms & Strengths

Intravenous injection: 1,100 kBq/mL (30 microcuries/mL) at the reference date

Adult Dosing

55 kBq (1.46 microcuries) per kg body weight administered as a slow intravenous injection over 1 minute
Administered every 4 weeks for a total of 6 injections

Pediatric Dosing

Safety and effectiveness in pediatric patients have not been established

Indications

Treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease

Mechanism of Action

Alpha particle-emitting radiopharmaceutical that mimics calcium and forms complexes with bone mineral hydroxyapatite in areas of active bone growth
Delivers high-linear-energy-transfer alpha radiation locally to bone metastases, causing double-strand DNA breaks in adjacent cells

Contraindications

Pregnancy and women of childbearing potential
Concomitant use with chemotherapy (other than abiraterone plus prednisone/prednisolone) due to potential additive myelosuppression

Adverse Reactions

Nausea and vomiting
Diarrhea
Peripheral edema
Bone marrow suppression (thrombocytopenia, neutropenia, pancytopenia)
Injection site reactions

Drug Interactions

Concurrent myelosuppressive agents may increase the risk of severe bone marrow suppression
Calcium-supplementing products or chelating agents may theoretically interfere with the deposition of radium-223 in bone

Curated Content: Needs Vetting Before Put to Clinical Use