Strontium-89 Chloride, Injection STRON-she-um-89 KLOR-ide

What are other names for this medicine?

Type of medicine: antineoplastic (anticancer); radioactive medicine

Generic and brand names: strontium-89 chloride, injection; Metastron

What is this medicine used for?

This medicine is a radioactive drug. It is given by injection (shot) to relieve the pain of cancer that has spread to the bones.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bone marrow problems or low platelet counts
• kidney or bladder problems

Tell your provider if you have recently had chemotherapy or radiation therapy.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while taking this medicine.

How do I use it?

This medicine is given by a healthcare provider trained in the use of radioactive drugs. How many doses you need is based on your response to the medicine, your symptoms, and how the medicine affects your blood. Repeat doses are generally given 90 days (or more) apart. Your healthcare provider will determine how often these shots will be given. Keep all appointments for these shots.

What should I watch out for?

You may feel a slight increase in bone pain for 2 to 3 days starting 2 to 3 days after the injection. Your healthcare provider will advise you about taking your regular pain medicine until this medicine takes effect. After 1 or 2 weeks, the bone pain should start to lessen and eventually go away for several months. Relief from pain usually lasts several months after a single injection. If the pain returns, contact your healthcare provider.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

During the week after an injection (before the medicine binds to the bone), this radioactive medicine is present in the blood and urine. To avoid contamination:

• Use a regular toilet (not a urinal) if one is available, and flush it twice.
• Wipe up spilled urine with a tissue and flush it away.
• Always wash your hands after using the toilet.
• Immediately wash any linen or clothing stained with urine or blood. Wash these items separately and rinse well.
• Wash away blood if you get a cut.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine. It is important to tell all healthcare providers that you are receiving strontium-89 (Metastron) injections.

If you travel, carry some form of identification that says you are taking this medicine. This medicine may set off certain kinds of screening devices.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Chest pain; unusual bleeding or bruising; blood in urine or bowel movements; unexplained low back pain, fever, or sore throat; unusual weakness or dizziness; trouble urinating.

Other: Flushing, slight increase in pain for 2 to 3Â days.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain food may also interact. Talk to your healthcare provider if you are taking:

• aspirin or other salicylates
• clopidogrel (Plavix)
• dipyridamole (Persantine, Aggrenox)
• medicines or supplements that contain calcium
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.