strontium 89 chloride (Rx)

Brand and Other Names:Metastron
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1 MCi/mL

Bone Pain from Skeletal Metastases

148 MBq (=4 mCi) slow IV injection OR

1.5-2.2 MBq/kg (= 40-60 uCi/kg)  

Repeat doses not recommended more frequently than 90 days interval

Safety and efficacy not established

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Adverse Effects

Frequency Not Defined

Bone marrow toxicity

Renal impairment

Flushing after rapid injection

Hot flush

Transient increase in bone pain

Chills/fever

Septicemia

Thrombocytopenia

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Warnings

Contraindications

Hypersensitivity

Cautions

Platelet < 60,000/mm³; WBC < 2400/mm³

Pain relief may take 7-20 days after injection

Only for cancers involving bone

Bone marrow toxicity may occur

Evaluate risk/benefits in patients with renal impairment (excreted renally)

Nor for use in patients with cancer not involving bone or short life expectancy

Incontinent patients may require urinary catherization to reduce radioactive contamination

Use only under the supervision of experienced personnel

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Pregnancy & Lactation

Pregnancy Category: D

Lactation: excreted in breast milk

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Emits beta radiationthat is taken up by primary bone and metastatic bone lesions, Reduces pain

Pharmacokinetics

Half-Life: 50.5 days

Duration: 6-12 months

Onset: 7-20 days

Excretion: urine (2/3) & feces (1/3)

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Administration

IV Administration

Slow IV over 1-2 min

Storage

Store inside transportation container

Expires 28 days after calibration (dates stated on label)

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Images

No images available for this drug.
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Patient Handout

Patient Education
strontium-89 chloride intravenous

STRONTIUM-89 CHLORIDE - INJECTION

(STRON-shee-um KLOR-ide)

COMMON BRAND NAME(S): Metastron

USES: This medication is used to relieve bone pain in people with bone cancer. Strontium-89 is a radioactive drug. It works by building up in certain cancer cells and causing them to die.

HOW TO USE: This medication is given by injection into a vein by a health care professional. It is injected slowly into a vein over 1 to 2 minutes. The effects of this medication should last for several months. If needed, repeat doses are given as directed by your doctor, usually after 3 months.Because this medication releases some radiation and may be present in the blood, urine, or stool for about 2 weeks after an injection, be careful to avoid contact with your blood, urine, or stool for at least 2 weeks after your treatment. To avoid splashing, sit down on the toilet seat each time you use the bathroom during the 2-week period after your injection. When you are done, flush the toilet twice. Afterward, wash your hands well with soap and water. Use medical gowns and gloves if you need to clean up any blood, urine, or stool. If any blood, urine, or stool comes into contact with your clothing, the clothing should be washed right away and separately from your other clothing.The dosage is based on your medical condition, weight, lab tests, and response to treatment.For the first few days after the injection, you may experience a slight increase in pain. After 1 to 2 weeks, the pain should decrease for several months. Tell your doctor if your pain does not get better or if it gets worse.

SIDE EFFECTS: Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding.This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills, cough).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using strontium-89, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bone marrow problems (such as low red/white blood cells and platelets), kidney problems.This medication can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using this medication. Strontium-89 may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication.It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Lab and/or medical tests (such as complete blood count, kidney function) should be done while you are using this medication. Women of childbearing age should have a pregnancy test before starting this medication. Keep all medical and lab appointments.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Not applicable. This medication is given in a hospital or clinic or doctor's office and will not be stored at home.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.