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Radium 223 dichloride Side Effects

For the Consumer

Applies to radium 223 dichloride: intravenous solution

As well as its needed effects, radium 223 dichloride may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking radium 223 dichloride, check with your doctor or nurse immediately:

More common:
  • Black, tarry stools
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • chest pain
  • chills
  • cough
  • fever
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • rapid weight gain
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • tingling of the hands or feet
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Less common:
  • Confusion
  • decreased frequency or amount of urine
  • dizziness
  • dry mouth
  • fainting
  • high fever
  • hoarseness
  • increase in heart rate
  • increased blood pressure
  • increased thirst
  • lightheadedness
  • loss of appetite
  • nausea
  • rapid breathing
  • sunken eyes
  • thirst
  • vomiting
  • weight gain
  • wrinkled skin

Minor Side Effects

Some radium 223 dichloride side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Diarrhea
Less common:
  • Redness, pain, and swelling at the injection site

For Healthcare Professionals

Applies to radium 223 dichloride: intravenous solution


The most common side effects (incidence of 10% or greater) were nausea, diarrhea, vomiting, and peripheral edema.

The most common hematologic laboratory abnormalities (incidence of 10% or greater) were anemia, lymphocytopenia, leukopenia, thrombocytopenia, and neutropenia.[Ref]


Very common (10% or more): Anemia (93%), lymphocytopenia (72%), leukopenia (35%), thrombocytopenia (31%), neutropenia (18%)
Common (1% to 10%): Pancytopenia (2%)[Ref]


Very common (10% or more): Nausea (36%), diarrhea (25%), vomiting (19%)[Ref]


Common (1% to 10%): Erythema, pain, and edema at the injection site[Ref]


Very common (10% or more): Peripheral edema (13%)
Common (1% to 10%): Dehydration (3%)


Common (1% to 10%): Renal failure and impairment (3%)


1. "Product Information. Xofigo (radium Ra 223 dichloride)." Bayer Pharmaceutical Inc, West Haven, CT.

It is possible that some side effects of radium 223 dichloride may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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