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QUADRAMET

Samarium (153Sm) Lexidronam Pentasodium Injection

Consumer Medicine Information

Disclaimer

This information answers some common questions about Quadramet. It does not contain all the available information nor does it take the place of talking to your specialist.

All treatments have risks and benefits. Your specialist has weighed the risk of you being treated with Quadramet against the benefits it is expected that you will receive.

If you have any concerns about your treatment, discuss them with your specialist.

Keep this information.

You may need to read it again.

What Quadramet is used for

Quadramet is used to help in relieving the pain causes by tumour deposits in bone. The drug is taken up particularly strongly in injured bone, which is often where the tumour is located. The radioactive component of the drug gives off radiation, which reduces tumour activity and associated pain.

The purpose of Quadramet is to relieve pain caused by tumour in bone. It is not a cure for cancer and will not have any effect upon tumour not in bone.

How long the relief will last is unpredictable, and may vary from weeks to months. Not all pain is due to tumour in bone, and this drug will not help relieve pain caused by tumour outside bone.

Quadramet is usually given following other treatments. Ask your specialist to explain why this treatment has been proposed for you.

For more information, ask for a copy of the booklet Nuclear Medicine, Answering Your Questions, available from the hospital, clinic or supplier.

Before you are given it

Tell the doctor who is to treat you if:

1. you are pregnant or intend to become pregnant
    It is not known whether Quadramet is harmful to an unborn baby when administered to a 
    pregnant woman. You should take steps to avoid becoming pregnant.

2. you are breast-feeding
    Quadramet has a serious potential to harm breast-fed infants. You should stop breast 
    feeding before and during your treatment with Quadramet.

3. you have had any chemotherapy or radiotherapy in the last 6 weeks
    Quadramet treatment may make worse unwanted side effects of previous chemotherapy
    or radiotherapy.

Preparation

You will be asked to drink at least 2 cups of fluid prior to injection. You may eat or drink or take your usual medications.

How Quadramet is used

The person administering the dose will insert a small plastic tube into a vein in your arm to allow the Quadramet to be given. It may sting during insertion and for a short time after, but then the injection can be given through the tube. After a check that the tube is in position, the Quadramet will be injected followed by a little water to make sure all the Quadramet has been injected. The tube will then be removed. Occasionally there may be some residual discomfort at the injection site and, rarely, some bleeding or bruising.

After being given the injection, you may need to wait in the clinic for about 2 hours to make sure that you have no problems with the treatment. Then you may leave.

After being given Quadramet

You should drink plenty of fluids in the first six hours after treatment, and empty your bladder frequently - at least every hour.

For the first 24 hours after your treatment you should be careful when going to the toilet not to spill any urine and to flush the toilet well.

Whenever possible, use a toilet rather than an urinal. Clean up spilled urine completely and wash your hands thoroughly.

No other activity will be affected by this treatment. You will be able to do anything afterwards that you could do before.

Side Effects

Tell the person treating you as soon as possible if you do not feel well after having had the injection of Quadramet.

About 10% of patients will experience a temporary increase in pain some time in the first week after treatment. This usually responds to an increase in pain killers and is temporary.

Treatment often produces a fall in the number of red cells and white cells produced in the bone marrow. This is usually temporary and does not pose a problem. You may need to
have weekly blood tests, starting 2 weeks after treatment, until this effect has gone.

In some patients, especially those who have received considerable chemo- or radio-therapy, the fall may be severe with increased chances of bleeding, infection or anaemia developing. This may require transfusions with blood products to correct, and may be fatal in a very
small number of cases. In the very unlikely event that the bone marrow should be severely affected, any further chemo- or radio-therapy may have to be delayed until it recovers.

Other less serious side effects experienced are diarrhoea, nausea and/or vomiting, fever and/or chills and dizziness. This is not a complete list. If you experience any of these or
other side effects check with your doctor.

Overdosage

The usual dose will be calculated by a qualified nuclear medicine physician and the possibility of overdosing is minimal.

Storage

Quadramet is stored by the hospital or clinic. It is stored in a freezer.

The Nuclear Medicine technologist or specialist will be responsible for checking the expiry date of the product before administrating it to you.

Product description

What it looks like

Quadramet is a clear to faintly yellow sterile solution that comes in a 10 ml vial.

Ingredients

Each ml of solution contains:

• < 200 micrograms of total Samarium
• 35 mg ethylenediaminetetramethylene (phosphonic acid monohydrate).
• 2..9 mg calcium ion
• 8.1 mg sodium ion
• chloride ion.

Supplier

Quadramet is supplied in Australia by:

Australian Radioisotopes
ANSTO
Private Mail Bag 1
MENAI NSW 2234

AUST R 62521

Australian Radioisotopes (ARI) is a trade name used by the Australian Nuclear Science and Technology Organisation (ANSTO), which is located at Lucas Heights, Sydney.

ARI manufactures and markets radioisotopes produced in ANSTO's research reactor, HIFAR, and in its National Medical Cyclotron.

This leaflet has been reviewed by various members of the Australian and New Zealand Society of Nuclear Medicine and the Australian and New Zealand Association of Physicians in Nuclear Medicine.

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