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(C) Vancouver
General Hospital.
This monograph may not be reproduced without permission.
For further information, please contact a Pharmacist. |
NAME OF DRUG
clodronate
CLASSIFICATION
Bone metabolism regulator
ALTERNATE NAME
BONEFOS, OSTAC
INDICATIONS
- potent inhibitor of osteoclastic bone resorption, used in treatment of diseases
associated with increased bone resorption, such as hypercalcemia of malignancy, osteolytic
bone metastases and Paget's disease of bone
- not recommended for management of hypercalcemia associated with malignant myelomas
(pamidronate is the preferred agent)
RECONSTITUTION AND STABILITY
- store at room temperature
- diluted solutions stable for up to 24 hours at room temperature
COMPATIBILITY
- compatible with NS, D5W
- do not mix in calcium containing infusion solutions, such as Ringer's Lactate
- do not mix with any other medication
ROUTES OF ADMINISTRATION
- IV infusion
- in 500mL IV solution (NS preferred for hypercalcemia)
- 300mg or less may be infused over 2 hours
- > 300mg must be infused over 4 hours
VH & HSC ADMINISTRATION POLICY
A - Not to be administered by direct IV route.
DOSAGE
Hypercalcemia of malignancy, malignant osteolysis:
- 1500mg IV x 1 or 300mg IV daily x 5 days (range 3-10 days)
Paget's Disease:
- 300mg IV daily x 5 days or 1500mg IV x 1
POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION
- thrombophlebitis, redness, swelling at IV site
- mild-moderate increases in serum creatinine
- acute phase reaactions such as fevers, myalgias, arthralgias
IMPORTANT IMPLICATIONS
- monitor ionized serum calcium - decreases in serum calcium generally occur within 2
days with maximum lowering capacity in 3 to 5 days
- monitor renal function - BUN, creatinine; if during therapy there is a deterioration
in renal function, stop infusion
- patients should be adequately hydrated throughout therapy
- slow infusion is essential
Sept 1997