No

Radiopharmaceutical

Relief of bone pain in patients with skeletal metastases

D

Patients with a history of hypersensitivity to any strontium-containing compounds, or any other component; pregnancy, lactation

Use caution in patients with bone marrow compromise; incontinent patients may require urinary catheterization. Body fluids may remain radioactive up to one week after injection. Not indicated for use in patients with cancer not involving bone and should be used with caution in patients whose platelet counts fall <60,000 or whose white blood cell counts fall <2400. A small number of patients have experienced a transient increase in bone pain at 36-72 hours postdose; this reaction is generally mild and self-limiting. It should be handled cautiously, in a similar manner to other radioactive drugs. Appropriate safety measures to minimize radiation to personnel should be instituted.

Most severe reactions of marrow toxicity can be managed by conventional means

Store vial and its contents inside its transportation container at room temperature

Adults: I.V.: 148 megabecquerel (4 millicurie) administered by slow I.V. injection over 1-2 minutes or 1.5-2.2 megabecquerel (40-60 microcurie)/kg; repeated doses are generally not recommended at intervals <90 days; measure the patient dose by a suitable radioactivity calibration system immediately prior to administration

Routine blood tests

Eat and drink normally, there is no need to avoid alcohol or caffeine unless already advised to do so; may be advised to take analgesics until Metastron® begins to become effective; the effect lasts for several months, if pain returns before that, notify medical personnel

During the first week after injection, strontium-89 will be present in the blood and urine, therefore, the following common sense precautions should be instituted:

2. Wipe away any spilled urine with a tissue and flush it away

3. Have patient wash hands after using the toilet

4. Immediately wash any linen or clothes that become stained with blood or urine

5. Wash away any spilled blood if a cut occurs

Injection, as chloride: 10.9-22.6 mg/mL [148 megabecquerel, 4 millicurie] (10 mL)

Brandi ML, "New Treatment Strategies: Ipriflavone Strontium, Vitamin D Metabolites and Analogs," Am J Med, 1993, 95(Suppl 5A):5A-69S-5A-74S.

Lincoln TA, "Importance of Initial Management of Persons Internally Contaminated with Radionuclides," Am Ind Hyg Assoc J, 1976, 37(1):16-21.

Robinson RG, Preston DF, Schiefelbein M, et al, "Strontium 89 Therapy for the Palliation of Pain Due to Osseous Metastases," JAMA, 1995, 274(5):420-4.