Samarium Treatment (Quadramet®)
(Samarium Sm-153 Lexidronam Pentasodium)
A Question and Answer Guide for Patients
What is a samarium treatment and how
does it work?
A samarium treatment (trade name
Quadramet®) is a type of radiation
treatment. It is a radiopharmaceutical—a
drug that is partly radioactive. Samarium is
given to help reduce pain in a person whose
cancer has spread to the bones (bone
metastases or bone mets). The radioactive
material in the samarium treatment goes into
the cancer cells. It does not go into healthy
bones or tissues. The treatment gets into the
bones through the bloodstream. Samarium
can reach cancer cells in bones throughout
the body. Left over drug is passed out of the
body through the urine.
What are bone metastases?
Bone metastases (mets) are parts of bone
that contain cancer cells. Bone mets occur
when cancer cells travel from the primary
site (prostate, breast, lung, etc.) and lodge
within bone tissue. Bone mets can be very
painful. Sometimes they are very hard to
relieve with pain medicines alone.
What can I do if my normal pain
medicine doesn’t help with this kind of
Keeping control of cancer pain is very
important. Some patients get relief from
regular radiation treatments. Others get help
from a blend of radiation treatments and
pain pills. A samarium treatment is a further
option. It has few side effects and can
relieve pain in many areas.
How is a samarium treatment given?
A samarium treatment is given during a 2-3
hour clinic appointment. At the start of the
appointment, an IV is put into a vein in your
hand or arm. IV fluids are then given. This
is done to ensure that you are well hydrated.
The samarium is then given. It is injected
into the IV, over 1-2 minutes, by the doctor.
Medical physicists are present to monitor the
injection of the drug. This is followed by
more IV fluids. Then the IV can be
removed. A patient getting samarium must
pass urine into a clinic toilet before leaving.
At home, after urinating, you will need to
double flush the toilet for the next 24 hours.
This is because some of the radioactive drug
is passed out of the body through urine.
You should use good hand washing during
Are there any side effects from a
Samarium can decrease your blood platelet
counts for a few weeks. Your doctor will
check your blood platelet test before the
treatment. This lab work can be done by
your local doctor. In about 8 weeks, your
blood counts should return to pre-treatment
levels. Your doctor may order a blood
platelet test after the treatment.
If you notice unusual amounts of bleeding or
bruising, call the Radiation Oncology Clinic
right away at (608) 263-8500. Most patients
do not have any problem with their blood
platelet counts after a samarium treatment.
When will I start to notice pain relief?
Some patients notice pain relief as soon as 1
week after treatment. Others take longer to
respond. A few patients may not get any
pain relief from this type of treatment.
Patients who respond to this type of
treatment will find that their pain continues
to lessen for 3-4 weeks after the treatment.
Many patients find that they can reduce the
amount of pain medicines they take. The
pain relief from a samarium treatment
generally lasts about 4 months.
Some patients may notice an overall
increase in boney pain in the first 24-72
hours after getting a samarium treatment.
This can be a sign that the drug has been
absorbed into the bones and is going to work
on the cancer cells. This type of increase in
pain will go away in a few days. It can be
lessened by over-the-counter products like
Advil®, Tylenol®, or Aleve®. Your doctor
may also prescribe stronger pain relievers
for this time period.
What if the pain returns?
If you get good pain relief after a samarium
treatment, but the pain returns after a few
months, call your doctor. Some patients get
more than one samarium treatment.
Are there any safety measures I should
There are some basic safety measures you
should take for a couple of days after getting
a samarium treatment. These measures will
protect you and others:
Drink at least two cups (one pint) of
water, juice, or other liquid just
before you receive your treatment.
This will help to fill your bladder. It
can protect it from left over
Radiation will be present in your
urine for about 12 hours after the
treatment. Be sure to drink extra
fluids for 12-18 hours after the
treatment. You should also pass
urine often. Use a toilet if at all
possible. Double flush the toilet for
the first 24 hours after getting the
drug. If you must use a urinal or
bedpan, carefully dispose of the
urine in a toilet.
Flush the toilet twice after passing
urine into it. Use toilet paper to
absorb any spills. Flush the toilet
paper. Wash your hands well.
If any urine or blood gets on your
clothing, wash the clothing right
Other safety measures
If you are pregnant or are trying to
get pregnant you should not get a
samarium treatment. Birth control
measures should be used until your
samarium treatment is over. Nursing
mothers should not get this
Tell your doctor if you have ever had
a bad response to phosphonate drugs
(medicines used in bone scans).
Will I be able to be close to other people?
You do not have to change how you act with
your friends or family after your treatment.
The amount of radiation that they might be
exposed to is quite small. It is about the
same as having an x-ray.
What about sexual contact?
We suggest that you refrain from sexual
contact for about 12 hours. After that time,
any left over radioactive material will be
cleared from your system.
Should I tell people that I’ve been given a
You should tell your health care providers
about your treatment for the first 2 months
after the treatment. This includes your
dentist, doctor, nurse, and/or pharmacist. If
your provider has any questions, he or she
can call your doctor at (608) 263-8500.
Your provider can also call the maker of
Quadramet®, Berlex Professional Services,
at 1-800-888-4112. No one else needs to
know about your treatment unless you
choose to tell them.
Will receiving a samarium treatment
affect my daily routine?
It takes about 12 hours for the leftover
radiation from the treatment to be cleared
from your body. There is no reason to limit
your daily activities. You may exercise and
drive your car. You can enjoy being with
friends and family. Feel free to follow your
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright ©12/2016 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6624