In the U.S.—

In Canada—

• Antineoplastic

Strontium chloride Sr 89 ( STRON-shee-um KLOR-ide) is a radiopharmaceutical (ray-dee-oh-far-ma-SOO-ti-kal) . Radiopharmaceuticals are radioactive agents that may be used to diagnose some diseases by studying the function of the body's organs or to treat certain diseases.

Strontium chloride Sr 89 is used to help relieve the bone pain that may occur with certain kinds of cancer. The radioactive strontium is taken up in the bone cancer area and gives off radiation that helps provide relief of pain.

Strontium chloride Sr 89 is to be given only by or under the direct supervision of a doctor with specialized training in nuclear medicine or radiation oncology. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of receiving the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For strontium chloride Sr 89, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to bone tumor–seeking medicines, like strontium chloride Sr 89. Also tell your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in either humans or animals. However, to avoid exposing the fetus to radiation, strontium chloride Sr 89 is not recommended for use during pregnancy. Be sure you have discussed this with your doctor.

Breast-feeding—Strontium chloride Sr 89 may pass into the breast milk. If you must receive this radiopharmaceutical, it will be necessary for you to stop breast-feeding. Be sure you have discussed this with your doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information about its use in children.

Older adults—Strontium chloride Sr 89 has been used in older people and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving strontium chloride Sr 89, it is especially important that your doctor know if you are taking any of the following:

• Calcium-containing medicines—These medicines may keep the strontium chloride Sr 89 from being taken up by the bone

• If you have ever been treated with x-rays or cancer medicines—Cancer medicines or radiation therapy may increase the harmful effects of strontium chloride Sr 89 on the bone marrow

Your doctor may have special instructions for you to follow to get ready for your treatment. If you do not understand them or if you have not received such instructions, check with your doctor in advance.

If you have a problem controlling your bladder, tell your doctor before receiving strontium chloride Sr 89. Special precautions will need to be taken to prevent contamination of clothing, bed linen, and the environment.

Dosing—

The doses of radiopharmaceuticals will be different for different patients and for the different types of treatments. The amount of radioactivity of a radiopharmaceutical is expressed in units called becquerels or curies. The usual adult dose of strontium chloride Sr 89 is 148 megabecquerels (4 millicuries). The dose you receive depends on your size, age, and blood test measurements (blood counts). The amount of radiation received by specific areas of the body to treat a disease is many times higher than from any diagnostic test, such as x-rays and nuclear medicine scans. Repeated doses may be necessary, depending on the kind of disease you have and how your body is responding to treatment.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects. You may need to have blood tests done regularly.

Follow these guidelines for 1 week after receiving strontium chloride Sr 89, to help reduce the chance of contaminating other persons or the environment:

• Use a normal toilet, if available, instead of a urinal.
• Strontium chloride Sr 89 is passed in the urine and feces. To prevent contamination of your home environment, flush the toilet twice after using.
• Wipe any spilled urine with a tissue and flush it away.
• Wash your hands after using or cleaning the toilet .
• Wash your clothes and bed linens immediately if they become soiled with your urine or blood. Wash them separately from other clothes.
• If you cut yourself, wash away any spilled blood .

Strontium chloride Sr 89 can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If your blood count becomes abnormally low, there are certain precautions you can take, to reduce the risk of infection or bleeding, such as:

• With abnormally low white blood cell counts:
  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• With abnormally low platelet blood counts:
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

Along with its needed effects, a medicine may cause some unwanted effects. When strontium chloride Sr 89 is used at recommended doses, side effects usually are rare. However, blood problems, such as a decrease in the number of white blood cells or platelets, may occur in some patients.

Check with your doctor immediately if any of the following side effects occur:

• Rare
  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness;  fever or chills;  lower back or side pain;  painful or difficult urination;  pinpoint red spots on skin;  unusual bleeding or bruising 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away after treatment as your body adjusts to the medicine. Check with your doctor if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Flushing;  increase in bone pain 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.