etidronate disodium

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.

etidronate disodium

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

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.
References in periodicals archive ?
Table 1 First-Generation Drugs Second Generation Non-nitrogen containing BPs (NNBP) (Aminobisphosphonate Drugs) Nitrogen containing BPs (NBP) Bonefos (clodronate) Actonel (risedronate sodium) Relative potency of 10 PO and IV Relative potency of 5000 PO formulations Aredia (pamidronate disodium) Didronel (etidronate disodium) Relative potency 100 IV Relative potency of 1 PO Boniva (ibandronate sodium) Skelid (tiludronic disodium) Relative potency 10000 Relative potency of 10 PO PO and IV formulations Fosamax (alendronate sodium) Relative potency 1000 PO Reclast (zoledronic acid) Relative potency 100000 IV Formulation Infused annually for osteoporosis FDA approval pendin Zometa (zoledronic acid) Relative potency 100000 IV Table 2 Risk factors Literature Of Review 1.
"When bone density measurement first was available, the only treatment for osteoporosis was calcium [or] the off-label use of medications such as sodium fluoride, and etidronate disodium. Since bone densitometry was introduced, there has been an explosion of new medicines.
"When bone density measurement first was available, the only treatment for osteoporosis was calcium as well as the off-label use of medications such as sodium fluoride and etidronate disodium. Since bone densitometry was introduced, there has been an explosion of new medicines.
The Genpharm product line includes atenolol tablets, baclofen tablets, etidronate disodium tablets, sotalol tablets (AF), triazolam CIV, tizanidine HCl tablets, zonisamide capsules and meloxicam tablets.
Procter & Gamble, which developed Didrocal(R) (etidronate disodium and calcium carbonate), the first bisphosphonate approved in Canada for postmenopausal osteoporosis, and Aventis Pharma Inc.
* Didronel [R] (etidronate disodium) -- Tablet; approved regimen is 200-400 mg once daily for 6 months; the higher dose (400 mg) is more commonly used; no food, beverages, or medications for 2 hours before and after taking; course should not exceed 6 months, but repeat courses can be given after rest periods, preferably of 3-6 months duration.
(bisoprolol fumarate/hydrochlorothiazide), co-marketed with Wyeth-Ayerst; Macrobid(R) (nitrofurantoin monohydrate/macrocrystals), Didronel(R) (etidronate disodium); and Asacol(R) (mesalamine).
A drug called etidronate disodium, approved for the metabolic bone disorder Paget's disease, has shown promise in treating osteoporosis.
In their three-year study, the scientists found that low doses of etidronate disodium -- a drug known to inhibit osteoclast activity in patients with Paget's disease, another bone disorder -- showed similar effectiveness in osteoporotic women without suppressing bone mineralization as higher doses had done in previous studies.
Separately, Genpharm LP is finding significant success with its recent launch of etidronate disodium tablets, USP.