Pluvicto Side Effects: Common and Severe Reactions Explained

Pluvicto is a medication used for the treatment of cancer of the prostate, which is the gland of the male reproductive system. 

It is specifically used for patients with metastatic cancer or when prostate cancer has spread to other parts of the body.

Although this medicine is effective in the management of prostate cancer, it is also associated with a few side effects.

This article discusses the common, severe, and long-term side effects of Pluvicto and how to minimize them. 

What are the side effects of Pluvicto?

Pluvicto might cause a few side effects, which primarily occur due to the radioactivity emitted by this drug. 

It is important to be aware of the common side effects of this medication and take steps to avoid or minimize them.

Low blood cell counts

Reduced blood cell count is a common side effect associated with the use of Pluvicto. Patients who are using this drug are often advised to check their blood cell counts at frequent intervals to help detect abnormal changes as soon as possible.

You should also watch out for the symptoms of low blood cell counts, such as:

  • Unusual tiredness or weakness
  • Shortness of breath
  • Pale skin
  • Bruising and bleeding more easily than normal
  • Difficulty stopping bleeding
  • Frequent infections with symptoms such as fever, sore throat, and mouth ulcers

Dry mouth

Dryness of mouth is a rare side effect associated with Pluvicto. The symptom is usually felt for a few hours after taking the Pluvicto injection.

You can get relief from this Pluvicto side effect by increasing your intake of water and fluids. 

You can also suck on ice cubes for about 30 minutes before Pluvicto injection or infusion and about 4 hours after the session to protect your mouth.

In addition, it is advisable to maintain optimum hygiene of the oral cavity. You may use alcohol-free mouthwash to maintain oral hygiene. 

Avoid eating hot, acidic, and spicy foods to prevent damage to the delicate oral mucosa.

Feeling unusually tired

Unusual tiredness and fatigue are commonly reported symptoms in patients treated with Pluvicto.

Here are some ways to get relief from weakness and tiredness:

  • Take adequate rest.
  • Take short naps as and when needed.
  • Be slow while getting up from sitting or lying down positions.
  • Eat healthy and balanced foods.
  • Increase your intake of water and fluids.
  • Try mild physical exercises such as walking.

In addition, you must avoid strenuous physical activities. Also, avoid driving or using machinery when you are feeling tired to avoid the risk of accidents.

Infertility

Pluvicto might affect the fertility of men and reduce their likelihood of fathering a child. In most men, this side effect persists for long. The fertility might be restored within a few months after the treatment is over.

Cancer

Since Pluvicto involves long-term, accruing radiation exposure, it might increase the risk for certain forms of cancer by triggering abnormal changes in healthy tissues.

Complications associated with pregnancy

Fathering a child by men during treatment with Pluvicto or within a few weeks of stopping the treatment can increase the risk of genetic defects in the child. 

These side effects can be avoided by avoiding pregnancy planning and using a condom during sex. 

These precautions must be followed while continuing the treatment with Pluvicto and for 14 weeks after the last dose. 

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How long do Pluvicto’s side effects last?

Most side effects of Pluvicto last for a short duration and disappear within a few hours after the session. However, some side effects, such as low blood cell counts and infertility, might persist for longer.

The long-lasting side effects of Pluvicto can be attributed to the radioactivity emitted by this medication. 

Are there any long-term side effects of Pluvicto?

Yes, some side effects of Pluvicto, such as infertility, low blood cell counts, cancer risk, and the risk of pregnancy complications in the child, might persist for a long.

Is Pluvicto safe?

Pluvicto is a safe medication when used under strict medical supervision. Although this drug is known to cause a few side effects, taking appropriate precautions can help you avoid or minimize them.

Here is some information about Pluvicto safety you should be aware of:

After receiving Pluvicto infusion, there will be some amount of radiation coming from your body. 

You can talk to a radiation safety officer to know the safety precautions you need to take to avoid the hazards associated with the radiation coming from your body.

Your Pluvicto radiation safety officer will give you instructions to follow after the infusion to avoid exposing others to the radiation.

The instructions to avoid radiation hazards include:

  • Do not use public transportation right after the infusion appointment. You may use a car service.  If you are traveling in the car with another person, sit as far away from them as you can.
  • Avoid close physical contact with other people. Stay at least 3 feet away from other people for most of the time for the first few days after treatment. But it is fine to be in close contact with someone for a short while, such as a brief hug.
  • Sleep alone for 4 days.
  • Avoid hugging or sharing a bed with pregnant women or small children for about 9 to 11 days.
  • Some radioactive material would stay in your body for a few days. It will be eliminated through your body fluids, especially urine (pee), saliva, and blood, during the initial few weeks after the treatment. Hence, drink lots of liquids after infusion to help the radiation from Pluvicto leave your body faster.
  • Practice good hygiene. Wash your hands with soap and water after using the bathroom.

Side effects of Pluvicto in the elderly

Joint pain

Joint pain is a rare side effect usually reported in elderly patients using Pluvicto. The higher incidence of joint pain in elderly patients could be attributed to age-related degenerative changes in the bone and joint tissues. 

Gentle exercises like walking may provide relief from joint pain in some cases. If needed, consider consulting with your healthcare provider about managing discomfort.

Kidney problems

Long-term use of Pluvicto might affect the functions of the kidneys. Some common symptoms of kidney dysfunctions include passing less urine than usual or reduced frequency of urination.

These adverse effects are likely to be more severe in elderly people using Pluvicto, possibly due to the decline in renal functions as a result of aging.  

If you develop signs of kidney dysfunctions, it is advisable to consult your healthcare provider, who may recommend additional tests to assess kidney functions.

Nausea and vomiting

Nausea and vomiting may occur for a few hours after taking the dose of Pluvicto. In some cases, these side effects persist for longer. 

As digestive functions tend to become weaker with advancing age, elderly people are at higher risk of experiencing these side effects. 

To avoid nausea and vomiting:

  • Avoid eating large meals. Instead, eat small meals at frequent intervals.
  • Drink clear fluids.
  • Limit your intake of spicy and fried foods.
  • Avoid foods with strong smells.

If nausea and vomiting persist, inform your doctor. Your healthcare provider might recommend anti-nausea medication to relieve these symptoms.

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Side effects of stopping Pluvicto

There is not much known about the side effects of stopping Pluvicto. However, you should not stop the treatment with Pluvicto unless advised by your physician. 

Regular medical appointments every six weeks are recommended to ensure the expected benefits of Pluvicto treatment and address any potential side effects under the guidance of your healthcare provider.

Conclusion

  • Pluvicto is an effective medication prescribed for the treatment of prostate cancer. 
  • This drug is known to cause a few side effects, some of which might last longer. 
  • It is important to watch out for the side effects of Pluvicto and take appropriate precautions to minimize the adverse effects.

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Sources

  1. Hennrich U, Eder M. [177Lu]Lu-PSMA-617 (PluvictoTM): The First FDA-Approved Radiotherapeutical for Treatment of Prostate Cancer. Pharmaceuticals (Basel). 2022 Oct 20;15(10):1292. doi: 10.3390/ph15101292. PMID: 36297404; PMCID: PMC9608311.
  2. Fallah J, Agrawal S, Gittleman H, Fiero MH, Subramaniam S, John C, Chen W, Ricks TK, Niu G, Fotenos A, Wang M, Chiang K, Pierce WF, Suzman DL, Tang S, Pazdur R, Amiri-Kordestani L, Ibrahim A, Kluetz PG. FDA Approval Summary: Lutetium Lu 177 Vipivotide Tetraxetan for Patients with Metastatic Castration-Resistant Prostate Cancer. Clin Cancer Res. 2023 May 1;29(9):1651-1657. doi: 10.1158/1078-0432.CCR-22-2875. PMID: 36469000; PMCID: PMC10159870.
  3. Lutetium (177Lu) Vipivotide Tetraxetan (Pluvicto): CADTH Reimbursement Review: Therapeutic area: Metastatic castration-resistant prostate cancer [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2023 May. Clinical Review. 

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