Pluvicto Side Effects and Tips for Managing Them

More common side effects of Pluvicto

Pluvicto can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult to tolerate.

Pluvicto’s commonly reported side effects include:

• laboratory abnormalities (test results are not within a normal range)
• decrease in:
  • lymphocytes, which are a type of white blood cell
  • neutrophils, which are a type of white blood cell
  • hemoglobin (red blood cells), which is also called anemia
  • platelets, which are cells that help the blood clot
  • estimated glomerular filtration rate, which is a measure of kidney function
  • calcium
  • sodium
  • appetite
• increase in:
  • aspartate aminotransferase, which is a type of enzyme
  • alkaline phosphatase, which is a type of enzyme
  • potassium
• fatigue (low energy)
• dry mouth
• nausea
• joint pain
• back pain
• constipation

For more information about some of these side effects, see “Tips for managing side effects.”

Mild side effects of Pluvicto

Mild side effects have been reported with Pluvicto. These include:

• fatigue (low energy)
• dry mouth
• nausea
• joint pain
• back pain
• constipation

In most cases, these side effects should be temporary, and some may be easily manageable. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. Do not stop Pluvicto treatment unless your doctor recommends it.

Pluvicto may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

For more information about some of these side effects, see “Tips for managing side effects.”

Serious side effects of Pluvicto

Pluvicto may cause serious side effects. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Pluvicto’s prescribing information.

If you develop serious side effects during Pluvicto treatment, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911. Or call your local emergency number right away.

Serious side effects that have been reported include:

• laboratory abnormalities (test results are not within a normal range)
• decrease in:
  • hemoglobin (red blood cells), which is also called anemia
  • platelets, which are cells that help the blood clot
  • estimated glomerular filtration rate, which is a measure of kidney function
  • calcium
  • sodium
  • appetite
• low white blood cells
• increase in:
  • aspartate aminotransferase, which is a type of enzyme
  • alkaline phosphatase, which is a type of enzyme
  • potassium
• musculoskeletal pain
• bleeding, including:
  • bleeding in the skull or brain
  • subdural hematoma, which is bleeding between the brain and skull caused by a broken vein
• urinary tract infection (UTI)
• acute kidney failure
• liver failure
• pneumonia, including aspiration pneumonia, which is a complication of pneumonia
• blood clot in the lung
• ischemic stroke, which is a blockage in a blood vessel that supplies blood to part of the brain
• sepsis, a life threatening illness from an infection and the immune system’s response to it
• COVID-19
• pancytopenia, which is a decrease in white blood cells, platelets, and red blood cells at the same time
• spinal cord compression, which is pressure caused by a mass on the spinal cord

For more information about some of these side effects, see the “Tips for managing side effects” section.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you develop a side effect during treatment with Pluvicto and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Pluvicto can cause an allergic reaction. But this side effect wasn’t reported in the drug’s studies.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They also can determine whether you should continue Pluvicto treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Your doctor can confirm whether you’ve had a serious allergic reaction to Pluvicto. If you have, they may switch you to a different treatment.

Tips for managing side effects

You can do some things to help make certain Pluvicto side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.

Decrease in hemoglobin (red blood cells), also called anemia

A decrease in hemoglobin (anemia) was a common side effect reported in studies of Pluvicto. Some symptoms of anemia are:

• fatigue (low energy) or exhaustion
• shortness of breath
• rapid or abnormal heartbeat
• headache
• difficulty with physical activity
• cold hands
• pale or yellow skin

Steps you can take to manage symptoms associated with this side effect include:

• informing your doctor to seek treatment advice
• increasing your intake of iron (See this article about iron for sources.)
• adding vitamin B12 to your diet (See this article about vitamin B12 for sources.)
• adding vitamin C to your diet (See this article about vitamin C for sources.)
• adding vitamin B9 (folate) to your diet (See this article about folate for sources.)

Your doctor will monitor your hemoglobin levels with regular blood tests during your Pluvicto treatment.

Decrease in platelets

A decrease in platelets (cells that help the blood clot) was a common side effect reported in studies of Pluvicto. Some symptoms of a decrease in platelets are:

• red, purple, or brown bruises on your skin
• bleeding from wounds that persists or is difficult to stop
• nosebleeds
• purple, brown, or red spots on the skin, usually on the stomach, legs, arms, buttocks, or eyelids or in the mouth, which is called petechiae
• blood in the urine, stool, or vomit (or dark vomit)

Steps you can take to manage symptoms associated with this side effect include:

• informing your doctor to seek treatment advice
• avoiding over-the-counter (OTC) medications such as ibuprofen or aspirin that thin the blood
• avoiding activities that put you at risk of bleeding injury, such as contact sports

Fatigue (low energy)

Fatigue (low energy) was a common side effect reported in studies of Pluvicto. Some symptoms of fatigue are:

• body temperature that’s higher than normal
• feeling sensitive to cold temperatures
• unexplained weight loss
• regularly having trouble falling or staying asleep
• depression

Steps you can take to manage symptoms associated with this side effect include:

• staying hydrated
• practicing healthy eating habits
• getting enough sleep
• exercising regularly
• avoiding things that cause you stress
• doing relaxing activities
• avoiding tobacco, alcohol, and illegal drugs (if applicable)

Musculoskeletal pain

Musculoskeletal pain was an uncommon side effect reported in studies of Pluvicto. Symptoms of musculoskeletal pain differ by the area affected. Musculoskeletal pain can affect the muscles, bones, joints, tendons, and ligaments. You might have the following in one or more areas:

• pain, which can feel:
  • sharp, dull, deep, or stabbing
  • like cramping or twitching
  • tender or sore
  • tingly or burning
• bruising
• cracking or popping sound
• weakness
• achiness and stiffness (sometimes with swelling)
• difficulty moving

Steps you can take to manage symptoms associated with this side effect include:

• resting the affected area and your body overall
• informing your doctor to seek treatment advice
• considering physical therapy if your doctor recommends it
• taking OTC or prescription pain medication that your doctor recommends
• massaging the affected area

Precautions for Pluvicto

Before starting Pluvicto treatment, discuss your health history with your doctor. Pluvicto may not be right for you if you have certain medical conditions or other factors affecting your health.

Because Pluvicto contains radiation, it requires taking some precautions to limit exposing others to radiation. Your doctor can advise you on these.

Be sure to talk with your doctor if any of the following apply to you:

• live and work in close contact with other people or both
• issues with any red blood cells, white blood cells, or platelets
• kidney problems
• current or planned pregnancy in your partner
• current or planned breastfeeding in your partner
• previous allergic reaction to this or a similar drug
• alcohol consumption

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.