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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

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.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

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.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
Multiple treatment approaches with diltiazem, disodium etidronate, probenecid, colchicine, minocycline, low-dose warfarin, and intralesional adrenal steroids have been explored, but no standard treatment has convincingly prevented or reduced calcinosis.
Disodium etidronate, a diphosphonate has been used with mixed results.
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].
Patients received oral intermittent cyclical etidronate therapy as disodium etidronate 400 mg daily on days 1-14, followed by 500 mg calcium as effervescent calcium citrate on days 15-90, after which the cycle was repeated continuously.
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.