etidronate disodium

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etidronate disodium

Didronel, Didronel PMO (UK)

Pharmacologic class: Bisphosphonate

Therapeutic class: Bone resorption inhibitor, hypocalcemic agent

Pregnancy risk category B


Blocks calcium absorption, slowing bone metabolism and reducing bone resorption and formation


Tablets: 200 mg, 400 mg

Indications and dosages

Paget's disease

Adults: 5 to 10 mg/kg P.O. daily as a single dose for up to 6 months, or 11 to 20 mg/kg P.O. daily for up to 3 months

Heterotopic ossification after hip replacement

Adults: 20 mg/kg P.O. daily for 1 month before and 3 months after surgery

Heterotopic ossification in spinal cord injury

Adults: Initially, 20 mg/kg P.O. daily for 2 weeks, decreased to 10 mg/kg P.O. daily for 10 weeks

Dosage adjustment

• Decreased glomerular filtration rate


• Hypersensitivity to drug or its components
• Abnormalities of esophagus, such as stricture or achalasia, that delay esophageal emptying
• Osteomalacia


Use cautiously in:
• renal impairment, long bone fractures, active upper GI condition (such as Barrett's esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis, or ulcers)
• pregnant or breastfeeding patients
• children (safety not established).


• Give with 6 to 8 oz of water 2 hours before first meal.
• Make sure patient doesn't eat for 2 hours after receiving dose.
• Know that therapy longer than 3 months is not recommended.

Adverse reactions

GI: nausea, constipation, stomatitis, diarrhea, esophageal irritation

Metabolic: hyperphosphatemia

Musculoskeletal: bone pain and tenderness, fractures, osteonecrosis of the jaw

Skin: rash


Drug-drug.Warfarin: increased prothrombin time

Drug-diagnostic tests.Serum phosphorus: increased level

Patient monitoring

• Monitor fluid intake and output.
• Monitor patient for GI discomfort. Divide doses as needed to ease symptoms.
• Assess bowel pattern. If constipation occurs, increase fluids and administer stool softeners, as prescribed.
• Closely monitor renal function tests and serum phosphorus level.

Patient teaching

• Instruct patient to take drug first thing in morning on an empty stomach, with 6 to 8 oz of water only and to stay upright for at least 30 minutes afterward.
• Instruct patient not to take drug with food because of decreased drug absorption.
• Tell patient not to consume highcalcium products, such as milk or antacids, or vitamins and mineral supplements high in calcium, iron, magnesium, or aluminum, within 2 hours of taking dose.

Tell patient to immediately discontinue drug and notify prescriber if severe chest pain, difficulty or painful swallowing, or new or worsening heartburn occurs.
• Advise patient to report bone pain or decreased range of motion.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

etidronate disodium

(ĕt′ĭ-drō′nāt′ dī-sō′dē-əm)
A drug that affects bone resorption and is used to treat Paget's disease, heterotopic ossification, and hypercalcemia of malignancy.

etidronate disodium

a regulator of calcium metabolism. Also called sodium etidronate.
indications It is prescribed in the treatment of Paget's disease and heterotopic ossification caused by injury to the spinal cord and after total hip replacement.
contraindication There are no known contraindications.
adverse effects Among the more serious adverse effects are bone pain both at pagetic sites and at previously asymptomatic sites, GI disturbances, and elevated serum phosphate concentrations.

etidronate disodium

Didronel® Metabolism An organic biphosphonate used to manage osteoporosis, Paget's disease of bone–osteitis deformans, heterotopic ossification, hypercalcemia of CA. See Coherence therapy, Osteoporosis.

etidronate disodium

; disodium etidronate bisphosphonate agent used in the prophylaxis and treatment of osteoporosis (i.e. cases non-respondent to alendronic acid or risedronate sodium); contraindicated in patients with reduced renal function

etidronate disodium

(ē´tədrō´nāt dīsō´dēəm),
n brand name: Didronel IV;
drug class: antihypercalcemic;
action: decreases bone resorption and new bone development (accretion);
uses: Paget's disease, heterotopic ossification, hypercalemia of malignancy.
References in periodicals archive ?
Disodium etidronate, a diphosphonate has been used with mixed results.
Comparison of changes in bone mineral density in idiopathic and secondary osteoporosis following therapy with cyclical disodium etidronate and high dose calcium supplementation.
Effect of intermittent cyclical disodium etidronate therapy on bone mineral density in men with vertebral fractures.
Disodium etidronate (1-hydroxyethylidene-1,1-bisphosphonate) was the first of these compounds to be introduced for clinical use and there is extensive research evidence and clinical data on its use in patients with osteoporosis [9, 10].
Disodium etidronate (9) which regress the formation of microliths at a dose of 10 mg/kg/day orally for a period of 1yr is useful in some patients.