Samarium Treatment (Quadramet ® ) (Samarium Sm-153 Lexidronam Pentasodium)

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Samarium Treatment (Quadramet

®

) 

(Samarium Sm-153 Lexidronam Pentasodium) 

 

A Question and Answer Guide for Patients

 

What is a samarium treatment and how 

does it work? 

A samarium treatment (trade name 

Quadramet

®

) is a type of radiation 

treatment.  It is a radiopharmaceutical—a 

drug that is partly radioactive.  Samarium is 

given to help reduce pain in a person whose 

cancer has spread to the bones (bone 

metastases or bone mets). The radioactive 

material in the samarium treatment goes into 

the cancer cells.  It does not go into healthy 

bones or tissues.  The treatment gets into the 

bones through the bloodstream.  Samarium 

can reach cancer cells in bones throughout 

the body.  Left over drug is passed out of the 

body through the urine. 

 

What are bone metastases? 

Bone metastases (mets) are parts of bone 

that contain cancer cells.  Bone mets occur 

when cancer cells travel from the primary 

site (prostate, breast, lung, etc.) and lodge 

within bone tissue.  Bone mets can be very 

painful. Sometimes they are very hard to 

relieve with pain medicines alone. 

 

What can I do if my normal pain 

medicine doesn’t help with this kind of 

pain? 

Keeping control of cancer pain is very 

important.  Some patients get relief from 

regular radiation treatments.  Others get help 

from a blend of radiation treatments and 

pain pills.  A samarium treatment is a further 

option.  It has few side effects and can 

relieve pain in many areas. 

How is a samarium treatment given? 

A samarium treatment is given during a 2-3 

hour clinic appointment.  At the start of the 

appointment, an IV is put into a vein in your 

hand or arm.  IV fluids are then given.  This 

is done to ensure that you are well hydrated.  

The samarium is then given.  It is injected 

into the IV, over 1-2 minutes, by the doctor.  

Medical physicists are present to monitor the 

injection of the drug.  This is followed by 

more IV fluids. Then the IV can be 

removed.  A patient getting samarium must 

pass urine into a clinic toilet before leaving.  

At home, after urinating, you will need to 

double flush the toilet for the next 24 hours.  

This is because some of the radioactive drug 

is passed out of the body through urine.  

You should use good hand washing during 

this time. 

 

Are there any side effects from a 

samarium injection? 

Samarium can decrease your blood platelet 

counts for a few weeks.  Your doctor will 

check your blood platelet test before the 

treatment.  This lab work can be done by 

your local doctor.  In about 8 weeks, your 

blood counts should return to pre-treatment 

levels.  Your doctor may order a blood 

platelet test after the treatment.   

 

If you notice unusual amounts of bleeding or 

bruising, call the Radiation Oncology Clinic 

right away at [phone].  Most patients 

do not have any problem with their blood 

platelet counts after a samarium treatment. 

---

When will I start to notice pain relief? 

Some patients notice pain relief as soon as 1 

week after treatment.  Others take longer to 

respond.  A few patients may not get any 

pain relief from this type of treatment. 

 

Patients who respond to this type of 

treatment will find that their pain continues 

to lessen for 3-4 weeks after the treatment.  

Many patients find that they can reduce the 

amount of pain medicines they take. The 

pain relief from a samarium treatment 

generally lasts about 4 months. 

 

Some patients may notice an overall 

increase in boney pain in the first 24-72 

hours after getting a samarium treatment.  

This can be a sign that the drug has been 

absorbed into the bones and is going to work 

on the cancer cells.  This type of increase in 

pain will go away in a few days.  It can be 

lessened by over-the-counter products like 

Advil

®

, Tylenol

®

, or Aleve

®

.  Your doctor 

may also prescribe stronger pain relievers 

for this time period. 

 

What if the pain returns? 

If you get good pain relief after a samarium 

treatment, but the pain returns after a few 

months, call your doctor.  Some patients get 

more than one samarium treatment. 

 

Are there any safety measures I should 

take? 

There are some basic safety measures you 

should take for a couple of days after getting 

a samarium treatment.  These measures will 

protect you and others: 



 

Drink at least two cups (one pint) of 

water, juice, or other liquid just 

before you receive your treatment.  

This will help to fill your bladder.  It 

can protect it from left over 

radioactive matter. 



 

Radiation will be present in your 

urine for about 12 hours after the 

treatment.  Be sure to drink extra 

fluids for 12-18 hours after the 

treatment.  You should also pass 

urine often.  Use a toilet if at all 

possible.  Double flush the toilet for 

the first 24 hours after getting the 

drug. If you must use a urinal or 

bedpan, carefully dispose of the 

urine in a toilet. 



 

Flush the toilet twice after passing 

urine into it.  Use toilet paper to 

absorb any spills.  Flush the toilet 

paper.  Wash your hands well. 



 

If any urine or blood gets on your 

clothing, wash the clothing right 

away. 

 

Other safety measures 



 

If you are pregnant or are trying to 

get pregnant you should not get a 

samarium treatment.  Birth control 

measures should be used until your 

samarium treatment is over.  Nursing 

mothers should not get this 

treatment. 



 

Tell your doctor if you have ever had 

a bad response to phosphonate drugs 

(medicines used in bone scans). 

 

Will I be able to be close to other people?  

You do not have to change how you act with 

your friends or family after your treatment.  

The amount of radiation that they might be 

exposed to is quite small.  It is about the 

same as having an x-ray.   

 

What about sexual contact? 

We suggest that you refrain from sexual 

contact for about 12 hours.  After that time, 

any left over radioactive material will be 

cleared from your system. 

 

---

Should I tell people that I’ve been given a 

samarium treatment? 

You should tell your health care providers 

about your treatment for the first 2 months 

after the treatment.  This includes your 

dentist, doctor, nurse, and/or pharmacist.  If 

your provider has any questions, he or she 

can call your doctor at [phone].  

Your provider can also call the maker of 

Quadramet

®

, Berlex Professional Services, 

at 1-800-888-4112.  No one else needs to 

know about your treatment unless you 

choose to tell them. 

 

Will receiving a samarium treatment 

affect my daily routine? 

It takes about 12 hours for the leftover 

radiation from the treatment to be cleared 

from your body.  There is no reason to limit 

your daily activities.  You may exercise and 

drive your car.  You can enjoy being with 

friends and family.  Feel free to follow your 

normal diet. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your health care team may have given you this information as part of your care. If so, please use it and call if you 

have any questions. If this information was not given to you as part of your care, please check with your doctor. 

This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because 

each person’s health needs are different, you should talk with your doctor or others on your health care team 

when using this information. If you have an emergency, please call 911. Copyright ©12/2016 University of 

Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6624