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Overview: Xofigo is used to treat prostate cancer. It provides radiation and helps kill cancer cells that have spread to the bones. Common side effects may include nausea and vomiting, diarrhea, and fluid retention. This medicine may lead to low levels of important blood cells and increase the risk of infections. Tell your health care provider if you have an infection or any unusual bleeding. Keep all appointments with your health care provider, including for blood work, while using this medicine. Xofigo is injected into a blood vessel. 

Uses

What is Xofigo used for?

Xofigo (radium Ra 223 dichloride) is commonly used to treat prostate cancer that is no longer responding to hormone treatments and has spread to a bone in your body but has not spread to any other areas. 

How Xofigo Works for Prostate Cancer

Xofigo may also be used for other conditions as determined by your health care provider.

How does Xofigo work (mechanism of action)?

Xofigo is a medicine that provides radiation to bones and helps to kill cancer cells that have spread to one or more of your bones. 

How is Xofigo supplied (dosage forms)?

Xofigo is available in an injectable form that is given by a health care provider.

How should I store Xofigo?

Xofigo is given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Xofigo?

The most common side effects of Xofigo are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Diarrhea
  • Fluid retention
  • Bone marrow suppression (see below)

There may be other side effects of Xofigo that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Xofigo?

While less common, the most serious side effects of Xofigo are described below, along with what to do if they happen.

Severe Allergic Reactions. Xofigo may cause allergic reactions, which can be serious. Stop using Xofigo and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Bone Marrow Suppression. Xofigo can damage bone marrow. This can lead to low blood levels of important cells, such as red blood cells, white blood cells, platelets, and neutrophils, and can lead to infections. This can be serious or even life-threatening. Keep all appointments for blood work so your health care provider can monitor your bone marrow while you use Xofigo. Tell your health care provider right away if you have any of the following symptoms of bone marrow suppression.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Warnings & Precautions

Who should not use Xofigo?

Allergies to Ingredients. People who are allergic to any of the following should not use Xofigo.

  • Radium Ra 223 dichloride
  • Xofigo
  • Any of the ingredients in the specific product dispensed 

Your pharmacist can tell you all of the ingredients in Xofigo.

What should I know about Xofigo before using it?

Xofigo is usually given by a health care provider in a hospital or clinic. It is given as an injection into a vein (IV).

You will need to drink plenty of water while using Xofigo. Tell your health care provider right away if you have a change in the amount of urine (pee) you have, the color of your urine, or any signs of dehydration, such as muscle cramps, constipation, or feeling very thirsty. 

You do not need to avoid physical contact with other people after using Xofigo. However, it is important to make sure that no other people come into contact with your urine or stools (poop) while using Xofigo and for at least 1 week after your last dose. You should flush the toilet several times after each use. Any clothing, bedding, or other materials that come into contact with your urine or stools should be separated from other items and washed right away. Any people who handle the soiled materials or help you use the bathroom should take precautions (such as wearing gloves) to avoid coming into contact with your urine or stools. 

Xofigo may make it hard for you to get your partner pregnant. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using Xofigo?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Xofigo is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines for Prostate Cancer. Using certain medicines for prostate cancer with Xofigo may increase the risk of side effects. Before using Xofigo, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Pregnancy. Xofigo may cause harm to a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. It is important that males use condoms and females use effective birth control during treatment with Xofigo and for 6 months after the last dose. 

Breastfeeding. People who can breastfeed are not usually prescribed Xofigo. 

How can I get more information about Xofigo?

For more information about Xofigo, you can visit the drugmaker’s website at www.xofigo.com or call them at 855-696-3446.

Interactions

Does Xofigo interact with foods or drinks?

There are no known interactions between Xofigo and foods or drinks.     

It is unknown if drinking alcohol will affect Xofigo.

Does Xofigo interact with other medicines (drug interactions)?

There are no known interactions between Xofigo and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

This may not be a complete list of medicines that can interact with Xofigo. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Xofigo?

If you or someone else has used too much Xofigo, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Xofigo?

Xofigo is given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving Xofigo as scheduled. If you miss an appointment, call your health care provider right away to reschedule.