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etidronate (Didronel)

Tradename: Didronel. Indications: 1) Paget's disease of the bone a) 5-10 mg/kg/day, do not exceed 6 months b) 11-20 mg/kg/day, do not exceed 3 months 2) hypercalcemia of malignancy a) 20 mg/kg/day for 30 days b) continue for another 30 days if needed 3) hypertrophic calcification secondary to spinal cord injury a) 20 mg/kg/day for 2 weeks, then b) 10 mg/kg/day for 10 weeks 4) total hip replacement (complicated) a) 20 mg/kg/day for 1 month preoperatively b) 20 mg/kg/day for 3 months post-operatively 5) osteoporosis: 400 mg PO QD for 2 weeks every 3 months [4] - of little benefit for primary prevention or secondary prevention of vertebral fractures or femoral fractures [5] 6) hypercalcemia: - 7.5 mg/kg in 250 mL NS IV over 2 hours QD for 3 days 7) doses > 20 mg/kg/day are not recommended Dosage: Tabs: 200 & 400 mg. Pharmacokinetics: 1) oral bioavailability is low, take on empty stomach 2) not metabolized Adverse effects: 1) not common (1-10%) - fever - fluid overload - GI complaints - nausea, constipation, diarrhea, anorexia, dyspepsia, metallic taste - metabolic disturbances - hypomagnesemia, hypophosphatemia, elevated serum transaminases - bone pain 2) uncommon (< 1%) - occult fecal blood, increased risk of fractures, renal impairment, hypersensitivity, angioedema (rare), convulsions (rare), rash Drug interactions: - Ca+2 & antacids interfere with absorption Mechanism of action: 1) bisphosphonate 2) acts primarily on bone to inhibit resorption 3) inhibits osteoclastic activity

Interactions

drug interactions drug adverse effects of bisphosphonates

Related

hypercalcemia osteoporosis

General

bisphosphonate

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category C safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  5. Wells GA, Hsieh SC, Peterson J, et al. Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2024 Apr 9;4(4):CD003376. PMID: 38591743 PMCID: PMC11003221 (available on 2025-04-09)