Classes
DEA Class; Rx
Common Brand Names; Didronel
- Calcium Metabolism Modifiers;
- Bisphosphonate Derivatives
Description
Injectable and oral first-generation bisphosphonate with a lower potency and selectivity vs. newer second- and third-generation bisphosphonates
For Paget’s disease the drug has largely been replaced by newer bisphosphonates that are easier to use and have greater antiresorptive potency; also indicated for heterotopic ossification but treatment is costly
Not recommended by guidelines for osteoporosis treatment or prevention as lacks efficacy data proving fracture reduction
Indications
Contraindications
Osteomalacia
Hypersensitivity
Esophagus abnormalities (eg, stricture, achalasia) that delay esophageal emptying
Adverse Effects
- Convulsion
- Fever
- Hypocalcemia
- Hypomagnesemia
- Hypophosphatemia
- Bone pain
- Abnormal renal function
- Amnesia
- Confusion
- Depression
- Hallucination
- Headache
- Paresthesias
- Alopecia
- Rash
- Altered taste
- Gastritis
- Glossitis
- Hypocalcemia
- Hypersensitivity reactions
- Arthropathy
- Fracture
- Leg cramps
- Nephrotoxicity
- Renal insufficiency
Warnings
Enterocolitis, renal impairment
May cause local irritation of upper GI mucosa
Potentially causes severe esophagitis, esophageal ulcers and erosions
Ensure adequate intake of calcium, vitamin D
Osteonecrosis of the jaw, can occur spontaneously and is generally associated with tooth extraction and/or local infection with delayed healing; known risk factors include invasive dental procedures (e.g., tooth extraction, dental implants, boney surgery), diagnosis of cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders; risk of osteonecrosis of the jaw may increase with duration of exposure to bisphosphonates
Risk of severe bone, joint and/or muscle pain
At higher doses both resorption inhibition and bone growth inhibition increases
Pregnancy and Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
Maximum Dosage
20 mg/kg/day PO.
20 mg/kg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Etidronate disodium
tablet
- 200mg
- 400mg