This medication is used to treat prostate cancer and cancer that has spread to bones. Radium Ra 223 dichloride is a radioactive drug. It works by building up in certain cancer cells and causing them to die.

This medication is given by slow injection into a vein by a health care professional. It is given as directed by your doctor, usually every 4 weeks for a total of 6 injections.

The dosage is based on your medical condition, weight, lab tests, and response to treatment.

To prevent dehydration, it is important to drink plenty of fluids while you are being treated with this drug. Consult your doctor or pharmacist if you have any questions.

Because this medication releases some radiation and may be present in the blood, urine, or stool for about 1 week after an injection, avoid contact with your blood, urine, or stool for at least 1 week after your treatment. To avoid splashing, sit down on the toilet seat each time you use the bathroom during the 1-week period after your injection. When you are done, flush the toilet twice. Afterward, wash your hands well with soap and water. Use medical gowns and gloves if you need to clean up any blood, urine, or stool. If any blood, urine, or stool gets on your clothing, wash the clothing right away and separately from your other clothing.

Nausea, diarrhea, or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Dehydration can occur. The risk is increased if you have vomiting or diarrhea that doesn't stop, and you cannot drink normally. Contact your doctor right away if you notice any symptoms of dehydration, such as unusual dry mouth/thirst, fast heartbeat or dizziness/lightheadedness.

People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.

Tell your doctor right away if you have any serious side effects, including:

• easy bruising/bleeding
• signs of kidney damage (such as change in amount of urine)

This medication may increase the risk of bone fractures. Tell your health care provider right away if you have bone pain or changes in movement.

This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as sore throat that doesn't go away, fever, chills, cough).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using radium Ra 223 dichloride tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

This medication can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Tell your health care professional that you are using radium Ra 223 dichloride before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

This medication may increase your risk for other cancers (such as bone cancers). Talk to your doctor for details.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Radium Ra 223 dichloride is not recommended for use by women.

Males with female partners of childbearing age should ask about reliable forms of birth control while using this medication and for 6 months after stopping treatment. Their female partners should also use reliable forms of birth control for the same amount of time.

It is unknown if this medication affects sperm. If you plan to father a child, discuss the risks and benefits of this medication with your doctor.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

A product that may interact with this drug is:

• abiraterone

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Lab and/or medical tests (such as complete blood counts, kidney function) should be done while you are using this medication. Keep all medical and lab appointments.

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Not applicable. This medication is given in a hospital or clinic and will not be stored at home.

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).