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Samarium 153 Sm oxabiphor

Medical expert of the article

Internist, pulmonologist
, Medical Reviewer, Editor
Last reviewed: 03.07.2025

The radiopharmaceutical therapeutic drug Samarium, 153 sm oxabifor is developed and produced by the company "Radiopreparat", operating on the basis of the Institute of Nuclear Physics of the Academy of Sciences of the Republic of Uzbekistan.

Until recently, when diagnosing metastatic bone disease, an oncologist had only two drugs at his disposal: 89 Sr and 32 P, although the world experience of oncological practice uses isotopes of a much larger number of chemical elements in the treatment of this pathology. Today, a new drug that can help a patient and relieve his ever-increasing pain is Samarium, 153 sm oxabifor, a modern radiopharmaceutical. Pain syndrome in bone lesions increases as the disease progresses and becomes a prerogative throughout the entire period of therapeutic therapy. It is in this direction that the drug in question works. In parallel, the administered drug allows you to slow down the development and spread of the metastasis process, which is important for a progressive oncological disease.

ATC classification

V10XX Прочие радиотерапевтические средства

Active ingredients

Самарий 153 Sm Оксабифор

Pharmacological group

Радиопрофилактические и радиотерапевтические средства

Pharmachologic effect

Антипролиферативные препараты

Indications samarium 153 Sm oxabiphora

The drugs of this pharmacological group are developed for a narrowly targeted effect on the human body, that is, to solve a specific pathological problem. Indications for the use of Samarium also have only one focus - this is the relief of pain symptoms, which invariably manifests itself in metastatic bone disease (in oncological practice). This drug also allows you to slow down the spread of metastases in the bones.

Another area of application of the drug Samarium is rheumatological practice. It is used in pathology of the musculoskeletal system that has become chronic. The drug reduces the symptoms of arthralgia (periodic occurrence of pain syndrome in the joints, in the absence of characteristic signs and symptoms of their damage), leading to stable remission. In particular, pain symptoms of such diseases as deforming arthrosis, rheumatoid arthritis and other pathologies are relieved.

Release form

Based on the pharmacological focus of the drug, as well as due to its belonging to radioisotope agents, its release form is a medicinal solution, which is used for intravenous administration.

Samarium is a transparent liquid, colorless. 1 ml of the drug consists of several active chemical compounds, which determine the pharmacodynamics of the drug. This is samarium-153 ( 153 Sm), which is present from 240 to 1500 MBq, also included in the form of a tandem samarium oxabifor, which is represented by an amount of 25 to 100 mcg and sodium oxabifor in an amount of 15 to 25 mg.

There are also accompanying substances that allow maintaining the therapeutic properties of the drug at a high level - this is sodium chloride, as well as special clean water, which is used for injections and setting up droppers.

Depending on the concentration of active active substances, this drug comes to the pharmacological market in 15 ml vials, but with different levels of therapeutic effect: 500 MBq, 1000 MBq and 2000 MBq. The container containing the medicinal liquid is also packed in a special kit designed to isolate radioactive substances.

Pharmacodynamics

Medicines belonging to this group, almost all work in a targeted manner. Pharmacodynamics of Samarium is caused by accumulation of the isotope samarium-153 in the bone tissues of a sick person. At the same time, its selectivity is determined by the fact that it begins to accumulate directly in places affected by metastatic formations. Their deposition also occurs in destructive-inflammatory foci that change the bone tissues of the human body.

The effect of the drug is produced by the radiation of beta particles, which are emitted by the isotopes samarium-153 (153 is a mass number determined by Mendeleyev and included in his table). It is these rays that affect the affected area, as well as the surrounding nerve endings. Samarium, due to its pharmacological characteristics, shows high antiproliferative efficiency, and at the same time has an analgesic effect.

Samarium-153 isotopes also emit hard gamma radiation, which makes it possible, using special medical equipment such as a gamma camera, to record the distribution zone and the level of accumulation of the drug.

After the patient has completed a course of therapy with Samarium, osteoscintigraphy shows that the accumulation of the medicinal component in the affected tissues is two to three times higher than that which settles in symmetrical areas of the human body not affected by the disease, which confirms the selectivity of the effect of this drug.

Such a result of the examination is identical to the diagnostic indicators, which were carried out on the basis of osteotropic compounds of technetium - 99m. This indicator allows us to give recommendations for its use in the status of selecting a method of radionuclide treatment with samarium-153 oxabifor.

Pharmacokinetics

Pharmacokinetics of Samarium shows that the clinical effectiveness of the drug administration begins to be noticeably manifested not less than a couple of weeks after the procedure of administration of the radionuclide drug. The therapeutic effect itself is persistent and, depending on the individual characteristics of the patient, can last from three to six months.

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Dosing and administration

The drug in question is used in medical therapy as an intravenous injection. Due to its high radiation load, in order to ensure protection of medical personnel working with the patient during the procedure, Samarium is diluted with a 0.9% solution of sodium chloride (NaCl), taken in an amount of 50 to 100 ml, immediately before administration.

  1. In order to perform the pre-dilution procedure correctly, it is necessary to set up the intravenous infusion system for operation, insert the needle into the vein and begin dripping the sodium chloride solution.
  2. After a short period of time, the drip system is closed using a special clamp, and the entire required amount of Samarium is injected into a container containing NaCl using a medical syringe.
  3. After this, the intravenous infusion can be continued, but the patient will receive a diluted radionuclide drug.

The method of administration and dosage of the drug is prescribed by the attending physician - oncologist. The recommended starting dosage of the drug is 1.5 mCi per kilogram of the patient's weight. With a specific clinical picture of the disease, the administered amount of the active substance can be adjusted both downwards (1 mCi per kilogram of the patient's weight) and upwards (2-1.5 per kilogram of the patient's weight).

If there is a therapeutic need, three months after the first procedure, the administration of Samarium can be repeated.

Based on the radioactivity of the drug used, this procedure is carried out only in a specialized medical institution that is equipped with an improved system of treatment facilities and filters. One of such places may be an oncology dispensary of regional subordination. After the patient has undergone this procedure, for the first two days, the patient's urine is not released immediately into the sewer system, but is kept for some time to undergo the procedure of splitting radionuclides.

Throughout the entire treatment period, it is necessary to constantly monitor the formula and other indicators of blood condition.

Samarium is not allowed to be administered to patients with a history of liver and kidney dysfunction due to severe disorders.

Use samarium 153 Sm oxabiphora during pregnancy

Due to its radioactivity, the use of Samarium during pregnancy, as well as during the period when a young mother breastfeeds her newborn child, is strictly contraindicated. If there is a clinical need to include this drug in the treatment protocol of a nursing woman, the baby must be weaned and transferred to artificial feeding.

Contraindications

Any pharmacological drug, due to its effect on the human body, has its limitations in use and introduction into the treatment protocol. There are also contraindications to the use of Samarium, which are represented by the following restrictions:

  1. Increased intolerance by the patient's body to the components of the drug.
  2. Severe renal and/or hepatic dysfunction.
  3. Thrombocytopenia is a decreased number of platelets in the patient’s blood plasma (less than 100.0x10 9 /l).
  4. Leukopenia is a decreased number of leukocytes in the patient’s blood plasma (less than 2.0x10 9 /l).
  5. Suppression of bone marrow hematopoiesis (hematopoiesis - the process of formation and development of blood cells).
  6. Another factor that prevents the administration of Samarium is if the patient has recently undergone massive myelosuppressive treatment.
  7. And also if there is a real possibility of compression damage to the spine.
  8. The drug is not permitted for use in the treatment protocol for children and adolescents who are under 18 years of age at the time of treatment.

Side effects samarium 153 Sm oxabiphora

Due to its pharmacological characteristics, the drug in question is quite aggressive and its use can cause negative symptoms. The side effects of Samarium are quite trivial and are caused by the following set:

  • Nausea. This uncomfortable condition can last for three days from the moment the drug is administered, after which its intensity gradually fades away. The second option for its relief is the introduction of one or two tablets of metoclopramide into maintenance therapy - an effective antiemetic that perfectly removes attacks of nausea.
  • For two weeks after the procedure, the patient feels increased pain. It occurs due to the radiation reaction of tissue cells located in the area of the pathological lesion. It is possible to relieve these symptoms by introducing metamizole sodium (a drug of the pyrazolone group) into the treatment protocol – a drug that has, among other things, narcotic analgesic properties. Along with it, drugs belonging to the pharmacological group of non-steroidal anti-inflammatory drugs (NSAIDs) can also be prescribed.

Overdose

Samarium has only recently entered the pharmaceutical market, so to date, overdose of the drug in question has not been described due to the lack of a sufficient research base.

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Interactions with other drugs

Any medicine has its own limitations for taking, but this primarily concerns the use of the drug in question in the conditions of monotherapy. When using in the treatment of complex therapy, it is necessary to know, in addition to the individual characteristics of each drug, the features of the interaction of Samarium with other drugs, in order to prevent deterioration of the patient's condition, aggravation of his anamnesis with additional pathological complications.

The specialist must know that the pharmacodynamics of the radionuclide Samarium 153 Sm oxabifor is therapeutically compatible with chemotherapy using its own drugs and hormone therapy, as well as with the method of influencing malignant neoplasms and metastatic structures with remote radiation therapy.

It is only necessary to regularly monitor the patient's condition and also monitor the main indicators of peripheral blood.

Storage conditions

This medicine is not available for free sale. Samarium storage conditions are subject to all "Rules for storage, accounting and transportation of radioactive substances, waste disposal".

They mainly focus on the fact that the drugs of this radiopharmaceutical group must be stored in such a way that the irradiation of medical personnel is not allowed, causing them harm. This radiation can also affect the level of accuracy of laboratory measurements and studies.

The laboratory should contain the amount of medication necessary to carry out daily procedures, and no more.

Samarium, as a drug that emits active beta particles and also manifests itself through gamma radiation, should be kept only in a special iron safe, in the presence of active gamma rays and with lead lining, located in the laboratory room.

Careful daily monitoring of the use of drugs in this category is necessary.

Transportation of such drugs, which include Samarium, is carried out in sealed containers to prevent spillage of the drug. The personnel accompanying the cargo, as well as the environment, must be protected.

The disposal of radioactive wastewater into absorption pits, wells, ponds intended for breeding fish and waterfowl, as well as into irrigated fields is strictly prohibited.

The place of disposal of radioactive substances must be equipped accordingly. Leakage is not allowed.

Shelf life

This medicine is diluted directly during intravenous infusion. The shelf life of the drug in question is quite limited and is only four days from the date of manufacture of Samarium. If the medicine was not in demand during the specified period, it is subject to disposal in compliance with all requirements detailed in the rules for storage, operation and disposal of radioactive substances and compounds.

Manufacturer

Радиопрепарат- Институт ядерной физики, АН Республика Узбекистан


Attention!

To simplify the perception of information, this instruction for use of the drug "Samarium 153 Sm oxabiphor" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.

Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.

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