disodium etidronate
disodium etidronate
CLINICAL USE
Bisphosphonate:Paget’s disease of bone Vertebral osteoporosis (Didronel PMO)
DOSE IN NORMAL RENAL FUNCTION
Paget’s disease: 5–20 mg/kg daily for 3–6 monthsVertebral osteoporosis: 400 mg daily for 14 days followed by 76 days of calcium carbonate 1.25 g (= 500 mg calcium)
PHARMACOKINETICS
Molecular weight                           :250 %Protein binding                           :Depends on calcium concentration and pH %Excreted unchanged in urine     : 50 Volume of distribution (L/kg)       :0.3–1.3half-life – normal/ESRD (hrs)      :1–6/– DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50     : Maximum dose = 5 mg/kg/day 10 to 20     : Maximum dose = 5 mg/kg/day – use with caution. (May also use Didronel PMO for osteoporosis.) <10           : Maximum dose = 5 mg/kg/day – use with caution. (May also use Didronel PMO for osteoporosis) DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min HD                     :Unknown dialysability. Dose as in GFR <10 mL/minHDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/minCAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsDo not give iron and mineral supplements, antacids or phosphate binders within 2 hours of an etidronate ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
Take on an empty stomach. Recommended that patients take with water at the midpoint of a 4 hour fast (i.e. 2 hours before and 2 hours after food)Oral bioavailability is very low; only about 4% of dose is absorbed OTHER INFORMATION
Renal clearance of etidronate is 1.2 mL/ minute/kg, whilst the total body clearance is 2.2 mL/minute/kgElimination is likely to be reduced in patients with renal impairment and elderly with reduced renal function necessitating caution. Uptake of etidronate by bone represents non-renal clearance
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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