Didronel PMO

etidronate disodium

Didronel, Didronel PMO (UK)

Pharmacologic class: Bisphosphonate

Therapeutic class: Bone resorption inhibitor, hypocalcemic agent

Pregnancy risk category B

Action

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

Availability

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

Contraindications

• Hypersensitivity to drug or its components

• Abnormalities of esophagus, such as stricture or achalasia, that delay esophageal emptying

• Osteomalacia

Precautions

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).

Administration

• 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

Interactions

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.

Didronel PMO

A brand name for EDITRONATE DISODIUM.
References in periodicals archive ?
The three bisphosphonates available in the UK are, alendronate (Fosamax), etidronate (Didronel PMO) and risedrinate (Actonel).
There are three bisphosphonates available in the UK, alendronate (Fosamax), etidronate (Didronel PMO) and risedronate (Actonel).
At the moment I'm taking Didronel PMO osteoporosis therapy for brittle bones.