Overdose

The risk of an overdose consists of an undesired high radiation exposure with the potential of acute toxic radiation effects. In this case, further treatment with 224RaCl has to be stopped immediately. The blood counts must be controlled in short-term intervals, because of a possible impairment of hematopoiesis.

Table 9 Patient Instructions, Side Effects, and Radiation Safety Considerations

Patients should receive written and verbal information about the procedure and side effects

Mobilization of the patient and physical therapy is necessary for treatment efficacy Patients benefit from the treatment in about 65% to 90% of cases Treatment response may be delayed by several months

Risk of a temporary increase of pain during the first days of therapy (treat with over-the-

counter anti-inflammatory drugs) Iridocyclitis may occur in rare cases; 224RaCl-treatment should be discontinued until the iridocyclitis has stopped Risks associated with intravenous administration of 224RaCl are local tissue necrosis and radiation exposure and risk of leukemia Patients should be advised to report any worsening or other unusual changes in health, and the patient should be given a phone number for contact he can reach at any time

Information about radiation safety considerations should be provided

224RaCl therapy should not be performed in pregnant or breastfeeding women Pregnancy should be avoided after treatment with 224RaCl by effective contraception for four to six months

Urinary contamination should be avoided by flushing the toilet two or three times and handwashing after every toilet use; men should urinate sitting down No additional home precautions are required

Abbreviation: RaCl, radium chloride.

Methods to reduce the radiation exposure after administration are not known.

However, this is a rather theoretical consideration, as each vial contains only 1 MBq 224RaCl at calibration time.

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