Ra Treatment Guidelines Dosage and Method of Administration

224RaCl is meant for intravenous use only. Currently, 10 injections at weekly intervals are administered with an activity of 1 MBq each (low-dose regimen). The drug is calibrated by the manufacturer at delivery. 224RaCl should be administered within three hours of the calibration time as indicated on the package (in Europe, normally Thursday or Friday at 12.00 hours). A dose adaptation for elderly patients is not required. The total activity of 10 MBq must not be exceeded. The shelf life of 224RaCl is three hours after calibration time.

Owing to possible tissue damage and necrosis, particular care has to be taken that the drug is not administered paravenously or leak out of the vessel and infiltrate the surrounding tissue. Before and after the injection of 224RaCl, rinsing the needle with isotonic saline solution is recommended to document intravenous free flow. An inline catheter with a short-running infusion of 100 ml NaCl, for example, may be used to assure safe intravenous administration of the radiopharmaceutical.

Contamination of people and objects by radioactivity excreted by the patients should be avoided. In case of surface contamination, the area should be washed off thoroughly. Any contamination can be detected by a small amount of secondary radiation (b and g radiation) induced by 224RaCl. Owing to insufficient knowledge about possible subsequent harms and side effects of repeated therapies, a therapy with a total activity of 10 MBq 224RaCl may be performed only once.

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