Quadramet

Generic Name: Samarium-153 Ethylenediaminetetramethylene Phosphate (EDTMP)
Product Name: Quadramet

Indication

Quadramet is used for the relief of bone pain caused by skeletal metastases that cause new bone growth. These metastases must be positively identified by bone scan prior to therapy.

Action

Quadramet contains a radioactive preparation of the element Samarium, which has been complexed with ethylenediaminetetra methylenephosphonic acid monohydrate (EDTMP) for intravenous injection. When cancer spreads to bones it causes new areas of growth, bone metastases. Samarium has an affinity for bone and quickly localises in areas of growing bone. Once concentrated in areas of bone metastases, Quadramet helps relieve the pain they cause. The mechanism by which it achieves this is unknown.

Dose advice

Do not use if the product is not delivered frozen. Quadramet should not be mixed or diluted with other solutions, as it contains certain molecules that form calcium precipitates. Any excess drug solution should be discarded.

Recommended dose is:

• 37MBq/kg administered as an IV injection over 1 minute
• Dose should be measured using a suitable radiation calibrating system immediately before administration
• At least 500ml of fluid should be consumed prior to administration, and the patient encouraged to void as often as possible following administration to reduce radiation exposure to the bladder.

Due to rapid clearance from the bloodstream (because of localisation to bone tissue) radiation exposure to other parts of the body is not a concern.

Schedule

Unscheduled.

Common side effects

Bone marrow suppression, resulting in decreased numbers of white blood cells and platelets, is common. This increases risk of infection and bleeding.

Other adverse effects include:

• Initial flare of pain, usually controllable with simple analgesics and limited to under 3 days
• Change in heart rhythm
• Increased blood pressure
• Abdominal pain
• Diarrhoea
• Nausea and vomiting
• Blood in the urine
• Infection
• Fever/chills
• Muscle weakness
• Dizziness
• Bronchitis
• Increased cough

Uncommon side effects

• Coagulation disorder
• Enlarged lymph nodes
• Bleeding under the skin
• Nosebleeds
• Pneumonia
• Pathological fracture
• Changes in skin sensation
• Spinal cord compression.

For further information talk to your doctor.