Patients' Injection Experience
PREPARATION
- Confirm adequate and stable baseline hematologic status prior to QUADRAMET® administration
- Consent forms signed, benefits verification in place
- Patient is adequately hydrated with a minimum of 500 mL of fluids
- Remind patients to arrive on time for their treatment
ADMINISTRATION
- Patient appears at a center licensed to administer radiopharmaceuticals
- Establish an intravenous line
- 1.0 mCi/kg QUADRAMET is administered intravenously over a period of one minute through a secure in-dwelling catheter and followed by a saline flush
- Patient should be encouraged to void as frequently as possible after injection
DISCHARGE INSTRUCTIONS
- Patient drinks a minimum of 500 mL (8 oz) and voids as often as possible during the first few hours after the injection
- For 12 hours after the injection caution must be taken to avoid urine spills/contact; thorough hand washing and flushing twice after using the toilet
- Some patients have reported a transient increase in bone pain shortly after injection (flare reaction)2
- This is usually mild and self-limiting and occurs within 72 hours of injection
- Such reactions are usually responsive to analgesics
FOLLOW-UP
- Beginning 2 weeks after QUADRAMET administration, blood counts should be monitored weekly for at least 8 weeks or until recovery of adequate bone marrow function
- Patients who experience a reduction in pain may be encouraged to decrease their use of opioid analgesics
REFERENCES:
- Sartor O. Overview of samarium Sm 153 lexidronam in the treatment of painful metastatic bone disease. Rev Urol. 2004;6(suppl 10):S3-S12.
- Quadramet® (Samarium Sm 153 Lexidronam Injection) prescribing information. April 2009.
