Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a prescription drug that’s used to treat prostate cancer in certain situations. Pluvicto comes as a solution for injection or infusion.

Pluvicto is used in adults to treat metastatic castration-resistant prostate cancer (mCRPC) that is prostate-specific membrane antigen (PSMA)-positive and has previously been treated using an androgen blocker and taxane-based chemotherapy (such as docetaxel).

To learn more about Pluvicto’s uses, see the “What is Pluvicto used for?” section.

Pluvicto basics

Pluvicto contains the active ingredient lutetium Lu 177 vipivotide tetraxetan. It belongs to a group of drugs called radiopharmaceuticals (also called radioligand therapeutic agents).

Pluvicto is a brand-name medication. A generic version of the drug isn’t currently available.

Pluvicto is used to treat prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) in adults. Before receiving treatment with Pluvicto, you must have previously received treatment with an androgen blocker and taxane-based chemotherapy (such as docetaxel) for your prostate cancer.

PSMA-positive mCRPC

Here are some fast facts on this type of cancer:

  • “PSMA-positive” means that diagnostic or imaging tests found the PSMA protein in prostate cancer cells. This protein is sometimes found in large amounts in prostate cancer cells.
  • “Castration-resistant” means that prostate cancer did not respond or stopped responding to hormone therapy such as apalutamide (Erleada), which is used to lower testosterone levels. (This treatment sometimes slows or stops the growth of prostate cancer.)
  • “Metastatic” means the cancer has spread beyond your prostate gland to other parts of your body, such as your bones or lymph nodes.

Your doctor can provide more information on the tests they’ll use to determine whether your prostate cancer is PSMA-positive.

Symptoms

Symptoms of PSMA-positive mCRPC can include:

  • problems starting or maintaining urination
  • frequent urination, particularly at night
  • erectile dysfunction
  • swelling or pain in your pelvis
  • loss of control over your bladder or bowels

How Pluvicto works

Pluvicto works to treat PSMA-positive mCRPC by specifically seeking out, binding to, and destroying prostate cancer cells that overexpress the PSMA protein. Pluvicto destroys prostate cancer cells by binding to and delivering radiation into the cancer cells.

Like most drugs, Pluvicto may cause mild to serious side effects. The lists below contain some of the more common side effects Pluvicto may cause, but they don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Pluvicto. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Pluvicto can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Pluvicto’s prescribing information.

Mild side effects of Pluvicto that have been reported include:

  • abdominal pain
  • appetite loss
  • constipation or diarrhea
  • dizziness
  • dry mouth
  • fatigue
  • headache
  • nausea and vomiting
  • peripheral edema
  • urinary tract infection

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Pluvicto can occur, but they aren’t common. If you have serious side effects from Pluvicto, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Pluvicto that have been reported include:

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 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 and can determine whether you should continue Pluvicto treatment.

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

If your doctor confirms you’ve had a serious allergic reaction to Pluvicto, they may have you switch to a different treatment.

Your doctor will recommend the dosage of Pluvicto that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Form and strength

Pluvicto is available as a liquid solution that’s given as an intravenous (IV) infusion (an injection into your vein over a period of time) or an IV injection. It comes in one strength of 27 millicuries (mCi) in 1 milliliter of solution (27 mCi/mL).

Recommended dosage

The recommended dosage of Pluvicto to treat prostate cancer is 200 mCi given every 6 weeks, up to a maximum of 6 doses. You may receive fewer than 6 doses if you experience intolerable side effects or if your cancer worsens during Pluvicto treatment.

To learn more about Pluvicto’s dosage, talk with your doctor.

How it’s given

Your doctor will explain how Pluvicto will be given to you. They’ll also explain how much you’ll be given and how often.

Pluvicto is available as a liquid solution that’s given as an IV infusion or an IV injection. You’ll receive infusions or injections at your doctor’s office or a clinic.

Pluvicto is a type of medication called a radiopharmaceutical, which means it contains radiation. During treatment with Pluvicto, it’s important to stay hydrated and empty your bladder as frequently as possible to lower your risk of radiation exposure to your bladder.

Also, after receiving Pluvicto, you’ll need to follow these precautions to lower the risk of exposing people who live with you to radiation from Pluvicto:

  • Stay at least 3 feet away from other members of your household for at least 2 days, or for at least 7 days if you live with children or pregnant people.
  • Avoid having sex for at least 7 days after your injection or infusion.
  • Sleep in a separate bedroom from:
    • pregnant people for at least 15 days
    • children for at least 7 days
    • other people living in your house for at least 3 days

Your doctor can answer any questions you may have about safety precautions to follow after each Pluvicto dose you receive.

Questions about receiving Pluvicto

Below are some common questions about receiving Pluvicto.

  • What if I miss a dose of Pluvicto? If you miss an appointment to receive an injection or infusion of Pluvicto, call your doctor’s office as soon as possible to reschedule.
  • Will I need to use Pluvicto long term? Maybe. You can receive up to 6 doses of Pluvicto, which are given at least 6 weeks apart. You may receive fewer than 6 doses if you experience intolerable side effects or if your cancer worsens during Pluvicto treatment.
  • How long does Pluvicto take to work? Pluvicto begins to work after you receive your first dose. But you likely won’t feel the drug working in your body. Your doctor will order tests throughout your treatment to check whether Pluvicto is working to treat your condition.

Below is important information you should consider before receiving Pluvicto.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

Pluvicto is not known to interact with other medications, herbs, supplements, foods, or alcohol. The manufacturer did not list any interactions in the drug’s prescribing information.

Before starting Pluvicto treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Pluvicto and alcohol

Alcohol is not known to interact with Pluvicto. But it’s important to stay hydrated during Pluvicto treatment, and alcohol causes dehydration.

In addition, alcohol may worsen certain Pluvicto side effects, including fatigue, diarrhea, and dry mouth. Because of this, your doctor may recommend that you limit the amount of alcohol you drink or that you avoid consuming it during treatment.

Pregnancy and breastfeeding

It’s not known whether it’s safe to receive Pluvicto during pregnancy or while breastfeeding. Pluvicto has not been studied in females and is approved only for use in males. Based on how Pluvicto works and because it contains radiation, Pluvicto may cause harm if used during pregnancy or while breastfeeding.

Note: In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. To learn more about this topic, see this article comparing sex and gender.

Birth control

If you have a partner who can become pregnant, you or your partner should use birth control during your Pluvicto treatment and for at least 14 weeks after your last dose.

Fertility

Treatment with Pluvicto can lead to temporary or permanent infertility. Your doctor should discuss this with you before you start treatment with Pluvicto. Talk with your doctor if you have questions or concerns about Pluvicto and fertility.

Warnings

Pluvicto can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Pluvicto is a good treatment option for you.

Talk with your doctor about your health history before you take Pluvicto. Be sure to tell them if any of the following factors apply to you:

Find answers to some commonly asked questions about Pluvicto.

Is Pluvicto covered by Medicare?

Maybe. Whether Pluvicto is covered by Medicare depends on certain factors, such as the Medicare plan you’re enrolled in.

To find out whether Pluvicto is covered by your plan, contact your Medicare plan administrator or your doctor. Your doctor’s office can work with Medicare to determine whether Pluvicto is covered. You can also reach out to Novartis Patient Support for help determining whether your Medicare plan covers Pluvicto.

What’s the life expectancy after Pluvicto treatment?

In studies, people who received Pluvicto lived for an average of about 15 months, while people who did not receive Pluvicto lived for an average of about 11 months. Keep in mind that some people in the study lived for a longer or shorter time than the average after receiving Pluvicto.

Life expectancy after Pluvicto treatment will vary from person to person. Talk with your doctor if you’d like to learn more about what you might be able to expect after Pluvicto treatment.

Pluvicto and Xofigo are both radiopharmaceuticals used to treat metastatic prostate cancer in adults. But there are some differences in when Pluvicto or Xofigo is prescribed for prostate cancer:

  • Pluvicto is prescribed for prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC).
  • Xofigo is prescribed for mCRPC that has spread to your bones and is causing symptoms such as bone pain but has not spread to your liver, your lungs, or other parts of your body.

Both drugs come as solutions inside vials. Xofigo is given as a slow IV injection. Pluvicto may be given as an IV infusion (an injection into your vein over a period of time) or an IV injection.

To learn more about how these drugs compare, talk with your doctor.

Pluvicto and Lutathera are used to treat different conditions:

  • Pluvicto is prescribed for treating prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant metastatic prostate cancer (mCRPC) in adults.
  • Lutathera, on the other hand, is prescribed to treat somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in adults and children ages 12 years and older.

Both drugs come as liquid solutions inside vials. Lutathera is given as an IV infusion (an injection into your vein over a period of time). Pluvicto may be given as an IV infusion or an IV injection.

To learn more about how these drugs compare, talk with your doctor.

Whether you have health insurance or not, cost may be a factor when you’re considering Pluvicto. What you’ll pay for Pluvicto may depend on several factors, such as your treatment plan and the pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. The manufacturer of Pluvicto, Novartis, has a program called Novartis Patient Support that may be able to help.

You can also check out this article to learn more about saving money on prescriptions.

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Pluvicto, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are similar to Pluvicto:

  • Jevtana (cabazitaxel)
  • Lynparza (olaparib)
  • Provenge (sipuleucel-T)
  • Rozlytrek (entrectinib)
  • Xofigo (radium Ra 223 dichloride)
  • Zytiga (abiraterone acetate)

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.