CLINICAL USE

Paget’s disease of bone

DOSE IN NORMAL RENAL FUNCTION

400 mg daily for 12 weeks

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 318.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 91
  • %Excreted unchanged in urine &nbsp &nbsp : 60
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp : No data
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : >100/205

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    60–90 Use with caution 30–60 Use with caution <30 Avoid

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Unlikely to be dialysed. Avoid

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Unlikely to be dialysed. Avoid
  • HDF/high flux &nbsp : Unknown dialysability. Avoid
  • CAV/VVHD &nbsp &nbsp &nbsp: Unlikely to be dialysed. Avoid

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs Calcium salts: reduced absorption

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    Take as a single dose with a glass of water at least 2 hours before or after meals, calcium supplements or aluminium or magnesium containing antacids Patients should ensure their calcium and vitamin D intake is adequate Calcium metabolism disorders should be corrected before starting therapy Bisphosphonates are mainly eliminated by excretion of unchanged drug in the urine .