Radium Ra 223 dichloride is used to treat prostate cancer that has spread to the bones and cannot be treated with surgery.

Radium Ra 223 dichloride may also be used for purposes not listed in this medication guide.

radium Ra 223 dichloride can increase your risk of bleeding or infection. You will need frequent medical tests.

Radium Ra 223 dichloride is given as an infusion into a vein. A healthcare provider will give you this injection.

Radium Ra 223 dichloride is usually given once every 4 weeks for a total of 6 injections. Your doctor will determine how long to treat you with radium Ra 223 dichloride.

Radium Ra 223 dichloride can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.

After you are treated with radium Ra 223 dichloride, your body fluids (urine, stools, vomit) will contain radioactive materials. Use a toilet rather than a urinal and sit on the toilet while urinating. Flush the toilet several times with the lid down after use.

Always wash your hands after using the bathroom. Avoid handling any clean-up of your stools or urine without wearing latex rubber gloves. If another person is handling your stools or urine, they should wear rubber gloves, disposable medical gown, eye protection, and a mask to cover the nose and mouth.

When cleaning any spills of bodily fluid, use only disposable cleaning cloths that can be flushed down a toilet. Ask your doctor or health department how to dispose of any bodily fluid spills that cannot be flushed down a toilet.

Wash any soiled clothing separately from the laundry of other people in your home.

Radium Ra 223 dichloride doses are based on weight. Your dose needs may change if you gain or lose weight.

Drink plenty of water each day to keep from getting dehydrated and to keep your kidneys working properly.

Usual Adult Dose for Prostate Cancer:

50 kilobecquerel (kBq) or 1.35 microcurie per kg body weight, IV, every 4 weeks

Duration of therapy: 6 doses

Comments: See manufacturer's product information for complete dosing instructions including decay correction factor table and calculation of correct volume for dosing.

Use: The treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease.

Radium Ra 223 dichloride can harm an unborn baby or cause birth defects if you father a child while using this medicine. Use condoms while you are being treated with this medicine and for at least 6 months after treatment ends.

Your sex partner should also use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose. Tell your doctor right away if a pregnancy occurs during this time.

This medicine may affect fertility (your ability to have children). However, it is important to use birth control to prevent pregnancy because radium Ra 223 dichloride can harm an unborn baby.

Call your doctor for instructions if you miss an appointment for your radium Ra 223 dichloride injection.

Since radium Ra 223 dichloride is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

The radioactivity in this medicine can pass into body fluids (urine, feces, vomit). For at least 7 days after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves and a disposable medical gown while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Radium Ra 223 dichloride may cause serious side effects. Call your doctor at once if you have:

• easy bruising, unusual bleeding, purple or red spots under your skin;

• a light-headed feeling, like you might pass out;

• dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;

• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath;

• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

• low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough, trouble breathing.

Common side effects of radium Ra 223 dichloride may include:

• nausea, vomiting, diarrhea;

• low blood cell counts; or

• swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

You may have an increased risk of bone fractures or death if you are treated with radium Ra 223 dichloride while you are also taking another medicine for prostate cancer called abiraterone (Yonsa, Zytiga) in combination with prednisone or prednisolone (steroid medicine).

Other drugs may affect radium Ra 223 dichloride, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.