Radium 223 Dichloride Injection (Xofigo
Useful information for patients and caregivers
Radium 223 dichloride injection (Xofigo®) is an intravenous (IV) injection of the radioactive
material radium 223. It is used to treat prostate cancer that is resistant to hormonal therapy. It is
given to men whose cancer has spread to the bones but not to other parts of the body. It is given
to men who are experiencing bone-related symptoms. The medical term for this condition is
metastatic castration-resistant prostate cancer, or mCRPC.
Before treatment with Xofigo
If you suffer from bone marrow problems (less blood cell production in the bone marrow),
your doctor will decide if this treatment is right for you.
This treatment can decrease the number of your blood cells. Before each injection of
Xofigo® you will need to have a blood test. This test can be done by your local doctor.
Depending on the results of the test, your radiation doctor will decide if the treatment can be
Be sure your radiation doctor knows if you are receiving any chemotherapy or extensive
radiation therapy, or have other medical conditions.
Dosing and administration of Xofigo
You will receive treatment with Xofigo® in a clinic or facility where doctors and staff have
been trained to give radiation therapy.
The recommended dosing schedule for this treatment is one IV injection every 4 weeks for 6
months (for a total of 6 IV injections). The use of Xofigo® beyond 6 injections has not been
studied. Each injection is given over 1 minute.
During and after treatment with Xofigo
The most common side effects of Xofigo® include nausea, diarrhea, vomiting, swelling of the
arms or legs (peripheral edema) and low blood cell counts. Tell your doctor if you have any side
effects that bother you or do not go away.
Make sure you keep your lab appointments while having this type of treatment. Report to
your doctor any signs of low blood counts (such as shortness of breath and/or tiredness caused by
anemia). Report any signs of bleeding (such as bruising) or infection (such as fever).
Stay well hydrated and report any signs of dehydration, or urinary or kidney problems.
There are no limits to contact with others after receiving Xofigo®.
Bathroom hygiene is important. Be sure to practice good personal hygiene while having this
treatment and for at least 1 week after the last injection. Radioactivity not taken up within the
bones will show up in feces, vomit, and urine. 48 hours after injection, a study showed the total
amount of Xofigo® in the feces was 13% (range 0-34%) About 63% of the radioactivity not
taken up within the bones is eliminated within 7 days.
Patients receiving Xofigo® should use a toilet when urinating or having a bowel movement.
Be sure to wash your hands thoroughly before and after flushing the toilet. Put the lid down on
the toilet whenever possible. Also, flush the toilet at least twice after each use.
Use condoms and make sure female partners who can have children use very good birth control
methods during and for a minimum of 6 months after treatment with Xofigo®.
Caregivers exposed to the patient’s body fluids should use common safety measures (gloves
and barrier gowns). Wear gloves to clean up any body wastes right away. Dispose of gloves and
gowns as in hospital policy. Exposure to Xofigo® might harm an unborn baby. Women who are
pregnant or who may become pregnant should not come not come in contact with Xofigo
without protection, such as wearing gloves.
Xofigo® Access Services has a variety of programs to support you. Learn more about these
programs by calling 1-855-6XOFIGO (1-855-696-3446). Xofigo® Access Counselors are
available from 9am to 8pm EST (Monday through Friday).
Xofigo® Access Services provides
• Financial and reimbursement support
• Prior authorization support
• Support for you and your caregivers
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Department of Nursing. HF#7538