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Samarium sm 153 lexidronam intraven.

Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.


(sa-MARE-ee-um SM 153/lexi-DROH-nam)



Samarium is a radioactive medication used to treat pain caused by cancer that has spread to the bone.

How To Use

This medication is injected into a vein (IV), as directed by your doctor. The dosage is based on your weight. Because this medication is radioactive, it is given only by specially trained health care professionals. Follow all instructions for proper use and handling of this product. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Radioactive drug will be present in your urine for several hours after receiving the dose. Drink at least 2 glasses (16 oz. or 500 ml) of water/fluid before receiving this medication and urinate as often as possible after receiving the dose. Your doctor may decide to give these fluids by vein (IV). Drinking or receiving these fluids will minimize the exposure of your bladder to radiation. Consult your doctor for details. Also, use the following precautions for at least 12 hours after the dose to minimize your exposure: use a toilet instead of a urinal and flush the toilet several times after each use; clean spilled urine or blood immediately; and wash your hands thoroughly after urinating. If blood or urine gets onto clothing, wash the clothing or store it for 1 to 2 weeks to eliminate contamination. Consult your doctor or pharmacist for details. You may experience a brief worsening of pain within the first 72 hours (3 days) after receiving the dose. The best pain relief generally occurs 3 to 4 weeks after receiving the dose. Consult your doctor or pharmacist about the use of other pain medications for break-through pain. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist.

Side Effects

Diarrhea or a temporary increase in bone pain (pain flare) may occur. If either of these effects persists or worsens, notify your doctor promptly. Tell your doctor immediately if any of these serious side effects occur: stomach/abdominal pain, fever, chills, sore throat, unusual bruising or bleeding, unusual weakness or tiredness, tingling or numbness of the hands/feet, cough, headache, skin infection. Tell your doctor immediately if any of these unlikely but serious side effects occur: chest pain, dizziness/lightheadedness, bloody or pink-colored urine, bloody nose, unusual bruising. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: unusually slow or fast heartbeat, swelling, trouble breathing, weakness/paralysis. If you notice any other effects not listed above, contact your doctor or pharmacist.


Tell your doctor your medical history, especially of: heart problems (e.g., heart failure, arrhythmia), kidney problems, radiation therapy, recent chemotherapy, immune system problems (bone marrow suppression), blood clotting problems (e.g., thrombocytopenia), spinal problems, urinary problems (e.g., incontinence), low blood calcium levels (hypocalcemia), any allergies. Because this medication can decrease your immune system function, do not have immunizations/vaccinations without the consent of your doctor and avoid contact with people who have recently received live vaccines (e.g., oral polio vaccine). Use caution with sharp objects like safety razors or nail cutters and avoid activities that may increase the chance of getting cut, bruised, or injured. This medication is not recommended for use during pregnancy. Consult your doctor for more details and to discuss reliable forms of birth control. It is recommended that men and women use birth control measures while being treated with this medication since samarium may cause fetal harm. It is not known if this drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.

Drug Interactions

Tell your doctor of all prescription and nonprescription medication you may use, especially: other cancer drugs, drugs that suppress the immune system (e.g., cyclosporine, prednisone), drugs that affect bone marrow (e.g., chemotherapy).


If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include: irregular heartbeat.


Laboratory and/or medical tests will be performed to monitor for side effects and response to treatment. Generally, your blood is monitored weekly for at least 8 weeks after treatment or until your bone marrow function returns to normal.

Missed Dose

If the dose is interrupted, contact your doctor immediately to establish new dosing recommendations.


Store in a freezer between 14 and -4 degrees F (-10 to - 20 degrees C) in a lead-shielded container, away from light and moisture. Thaw at room temperature (77 degrees F or 25 degrees C) before giving the dose. Use the drug within 8 hours of thawing. Discard any unused liquid. Consult your pharmacist for details.