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This product contains a radioactive medication. It is used to treat pain caused by cancer that has spread to the bone. It may help to make you more comfortable and may allow you to decrease the amount of pain medications you take.

If you miss a dose, contact your doctor immediately to establish a new dosing schedule.

This medication is injected into a vein 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 who must follow all proper use and handling instructions. Radioactive drug will be present in your urine for several hours after you receive the dose. Too much radiation can damage the bladder, so it is important to make sure the medication passes out of the bladder as soon as possible. Therefore, drink at least 2 glasses (16 ounces or 500 milliliters) of water or other 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. Consult your doctor for details. Also, to make sure you and those around you are exposed to as little radiation as possible, take the following precautions for at least 12 hours after the dose. Use a toilet instead of a urinal, and flush the toilet several times after each use. Clean up any blood and spilled urine immediately. Wash your hands thoroughly after urinating or coming in contact with blood. If blood or urine gets onto clothing, wash the clothing separately from other clothes, or store them safely in a separate place for 1 to 2 weeks to give the radiation time to become less harmful. Consult your doctor or pharmacist for more information. You may have mild, temporary worsening of pain within the first 3 days after receiving the dose. You may start to feel pain relief 1 week after the dose. The best pain relief generally occurs after 3 to 4 weeks. Consult your doctor or pharmacist about the use of other pain medications for sudden attacks of pain.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use. This medication can decrease your bone marrow function. This problem can lead to low blood cell counts and a weakened immune system. Your doctor will monitor you closely. Other treatments that have similar side effects (e.g., cancer chemotherapy drugs, radiation) should usually not be given at the same time as this medication. These treatments are usually timed for when your bone marrow function returns to normal. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

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

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: irregular heartbeat.

Before using this medication, 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, especially of: heart problems (e.g., heart failure, irregular heartbeat), kidney problems, urinary/bladder problems (e.g., incontinence), decreased bone marrow function, blood disorders (e.g., bleeding problems, low platelet count, blood clotting problems), weakened immune system, low blood calcium levels. Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received polio vaccine by mouth or flu vaccine inhaled through the nose. Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g., flu, chickenpox). To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports. This medication is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the risks and benefits with your doctor. Women should have a negative pregnancy test before treatment. It is recommended that men and women receiving this medication use at least 2 reliable forms of birth control (e.g., condoms, birth control pills) to prevent pregnancy. If you become pregnant or think you may be pregnant, tell your doctor immediately. Consult your doctor for more details and to discuss reliable forms of birth control. It is not known if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.

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

Diarrhea, dizziness, or a temporary increase in bone pain (pain flare) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Many people using this medication have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk. This medication can lower the body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection (e.g., fever, chills, persistent sore throat/cough, pain when you urinate). Tell your doctor immediately if any of these unlikely but serious side effects occur: easy or unusual bleeding/bruising (e.g., bloody nose, bloody/black/tarry stools, bloody/pink urine), unusual weakness/tiredness, pounding/persistent headache, fast/slow/irregular heartbeat. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: 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 any 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. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.