chromic phosphate

Class: Radiopharmaceutical

Generic Name: Chromic phosphate (KROE-mik FOSS-fate) 32
Trade Name: Phosphocol P32®

For which conditions is this drug approved? Chromic phosphate is FDA-approved to treat the leaking of fluid (effusion) into the peritoneum (sac surrounding the abdominal organs) or pleura (sac surrounding the lungs) as a result of advanced cancer. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Chromic phosphate belongs to a group of agents classified as radiopharmaceuticals. Chromic phosphate produces its anti-cancer effects by emitting radiation to tissues surrounding it.

How is chromic phosphate typically given (administered)? Chromic phosphate is administered by catheter into a body cavity (intracavitary) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with chromic phosphate. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

What are the common (occurs in 10-29% of patients) side effects of treatment with chromic phosphate?

• Nausea and vomiting
• Low levels of white blood cells
• Low levels of red blood cells (anemia)
• Low levels of platelets (thrombocytopenia)
• Abdominal cramping
• Feeling of discomfort
• Inflammation of the peritoneum
• Inflammation of the pleura
• Diarrhea
• Loss of appetite
• Weakness

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Chromium phosphate is a radioactive substance. Patients should speak with their physician about taking radiation precautions.

When should patients notify their physician?

• Difficulty breathing
• Extreme abdominal cramping
• Fever, chills, cough, sore throat, flu or cold-like symptoms
• Signs of infection – redness, swelling, pus, tenderness
• Persistent or severe fatigue
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Chest pain
• Dry cough
• Severe nausea or vomiting

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug.By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Important Limitations of Use

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