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| {{DrugProjectFormSinglePage
| | #REDIRECT [[Radium-223 chloride]] |
| |authorTag={{AP}}
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| |genericName=Radium chloride (Ra-223)
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| |indicationType=treatment
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| |indication=patients with castration-resistant [[prostate cancer]], symptomatic [[bone metastases]] and no known visceral metastatic disease
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| |adverseReactions=[[nausea]], [[diarrhea]], [[vomiting]], and [[peripheral edema]]
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| |blackBoxWarningTitle=<b><span style="color:#FF0000;">TITLE</span></b>
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| |blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
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| |offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Radium chloride in adult patients.
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| |offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Radium chloride in adult patients.
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| |offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Radium chloride in pediatric patients.
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| |offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Radium chloride in pediatric patients.
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| |contraindications=*Xofigo is contraindicated in pregnancy.
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| *Xofigo can cause fetal harm when administered to a pregnant woman based on its mechanism of action.
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| *Xofigo is not indicated for use in women.
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| *Xofigo is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, apprise the patient of the potential hazard to the fetus
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| |warnings=====Bone Marrow Suppression====
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| *In the randomized trial, 2% of patients on the Xofigo arm experienced [[bone marrow failure]] or ongoing [[pancytopenia]] compared to no patients treated with [[placebo]]. There were two deaths due to [[bone marrow failure]] and for 7 of 13 patients treated with Xofigo, bone marrow failure was ongoing at the time of death. Among the 13 patients who experienced [[bone marrow failure]], 54% required blood transfusions. Four percent (4%) of patients on the Xofigo arm and 2% on the placebo arm permanently discontinued therapy due to [[bone marrow suppression]].
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| *In the randomized trial, deaths related to vascular hemorrhage in association with [[myelosuppression]] were observed in 1% of Xofigo-treated patients compared to 0.3% of patients treated with [[placebo]]. The incidence of infection-related deaths (2%), serious infections (10%), and [[febrile neutropenia]] (<1%) were similar for patients treated with Xofigo and [[placebo]]. [[Myelosuppression]]; notably [[thrombocytopenia]], [[neutropenia]], [[pancytopenia]], and [[leukopenia]]; has been reported in patients treated with Xofigo. In the randomized trial, [[complete blood counts]] (CBCs) were obtained every 4 weeks prior to each dose and the nadir CBCs and times of recovery were not well characterized. In a separate single-dose phase 1 study of Xofigo, [[neutrophil]] and [[platelet]] count nadirs occurred 2 to 3 weeks after Xofigo administration at doses that were up to 1 to 5 times the recommended dose, and most patients recovered approximately 6 to 8 weeks after administration.
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| *Hematologic evaluation of patients must be performed at baseline and prior to every dose of Xofigo. Before the first administration of Xofigo, the [[absolute neutrophil count]] ([[ANC]]) should be ≥ 1.5 x 109/L, the [[platelet]] count ≥ 100 x 109/L and [[hemoglobin]] ≥ 10 g/dL. Before subsequent administrations of Xofigo, the [[ANC]] should be ≥ 1 x 109/L and the [[platelet]] count ≥ 50 x 109/L. If there is no recovery to these values within 6 to 8 weeks after the last administration of Xofigo, despite receiving supportive care, further treatment with Xofigo should be discontinued. Patients with evidence of compromised [[bone marrow]] reserve should be monitored closely and provided with supportive care measures when clinically indicated. Discontinue Xofigo in patients who experience life-threatening complications despite supportive care for [[bone marrow failure]].
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| *The safety and efficacy of concomitant chemotherapy with Xofigo have not been established. Outside of a clinical trial, concomitant use with chemotherapy is not recommended due to the potential for additive [[myelosuppression]]. If chemotherapy, other systemic radioisotopes or hemibody external radiotherapy are administered during the treatment period, Xofigo should be discontinued.
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| |alcohol=Alcohol-Radium chloride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
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| }}
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| {{Chembox new
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| | Name = Radium chloride
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| | Section1 = {{Chembox Identifiers
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| | CASNo = 10025-66-8
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| }}
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| | Section2 = {{Chembox Properties
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| | Formula = RaCl<sub>2</sub>
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| | MolarMass = 296.94 g/mol
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| | MeltingPt = }}
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| }}
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| '''Radium chloride''', RaCl<sub>2</sub>, was the first [[radium]] [[Chemical compound|compound]] to be prepared in a pure state and was the basis of [[Marie Curie]]'s original separation of radium from [[barium]].<ref>[[Marie Curie|Curie, M.]]; [[Andre Debierne|Debierne, A.]] (1910). ''C. R. Hebd. Acad. Sci. Paris'' '''151''':523–25.</ref> The first preparation of radium metal was by the [[electrolysis]] of a solution of radium chloride using a mercury cathode.
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| ==Preparation==
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| Radium chloride crystallises from solution as the di[[hydrate]]. It may be dehydrated by heating to 100 °C in air for one hour followed by 5½ hours at 520 °C under [[argon]].<ref>Weigel, F.; Trinkl, A. (1968). ''Radiochim. Acta'' '''9''':36–41.</ref> If the presence of other anions is suspected, the dehydration may be effectuated by fusion under [[hydrogen chloride]].<ref>Hönigschmid, O.; Sachtleben, R. (1934). ''Z. Anorg. Allg. Chem.'' '''221''':65–82.</ref>
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| ==Properties==
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| Radium chloride is a white solid with a blue-green [[luminescence]], especially when heated. It is less soluble in water than other [[alkaline earth metal]] chlorides, a fact which is used in the first stages of the separation of radium from [[barium]] by [[fractional crystallization]]. It is only sparingly soluble in [[Azeotrope|azeotropic]] [[hydrochloric acid]] and virtually insoluble in concentrated hydrochloric acid.<ref>Erbacher, O. (1930). ''[[Ber. Dtsch. Chem. Ges.]]'' '''63''':141–56.</ref>
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| Gaseous radium chloride exists as RaCl<sub>2</sub> molecules, as with other alkaline earth metal [[halide]]s. The gas shows strong absorptions in the visible spectrum at 676.3 [[nanometre|nm]] and 649.8 nm (red): the [[Bond dissociation energy|dissociation energy]] of the radium–chlorine bond is estimated as 2.9 [[electronvolt|eV]],<ref>Lagerqvist, A. (1953). ''Arkiv Fisik'' '''6''':141–42.</ref> and its [[Bond length|length]] as 292 [[picometre|pm]].<ref>Karapet'yants, M. Kh.; Ch'ing, Ling-T'ing (1960). ''Zh. Strukt. Khim.'' '''1''':277–85; ''J. Struct. Chem. (USSR)'' '''1''':255–63.</ref>
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| ==Uses==
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| Radium chloride is still used for the initial stages of the separation of radium from barium during the extraction of radium from [[pitchblende]]. The large quantities of material involved ([[tonne]]s of ore for [[milligram]]s of radium) favour this less costly (but less efficient) method over those based on [[radium bromide]] or [[radium chromate]] (used for the later stages of the separation).
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| ==Sources==
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| *''Gmelins Handbuch der anorganischen Chemie (8. Aufl.)'', Berlin:Verlag Chemie, 1928, pp. 60–61.
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| *''Gmelin Handbuch der anorganischen Chemie (8. Aufl. 2. Erg.-Bd.)'', Berlin:Springer, 1977, pp. 362–64.
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| ==References==
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| {{reflist|2}}
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| [[Category:Radium compounds]]
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| [[Category:Chlorides]]
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| [[Category:Metal halides]]
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