strontium ranelate

CLINICAL USE

Treatment of post-menopausal osteoporosis

DOSE IN NORMAL RENAL FUNCTION

2 g once daily

PHARMACOKINETICS

Molecular weight :513.5

%Protein binding :25

%Excreted unchanged in urine : 66

Volume of distribution (L/kg) :1

half-life – normal/ESRD (hrs) :60/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 Dose as in normal renal function10–30 See ‘Other Information’

<10 : See ‘Other Information’

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/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR=10–30 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsCalcium-containing compounds: separate administration by at least 2 hoursAntacids: separate administration by at least 2 hoursAntibiotics: strontium can reduce absorption of oral tetracycline and quinolones – suspend strontium therapy during treatment

ADMINISTRATION

Reconstition

Glass of water

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Give between meals as the absorption of strontium is reduced by food and milk productsInterferes with colorimetric methods of blood and urinary calcium concentrationsGive with calcium and vitamin D supplementsSteady state strontium levels are approximately 50% higher in patients with a GFR<25 mL/min compared to patients with normal renal function. No specific treatment effect was detected in patients with renal impairment Fluoride and strontium accumulation in bone does not correlate with osteoid tissue in dialysis patients.
Another study found that haemodialysis patients with osteomalacia developed high bone-strontium levels.
)There is no evidence of high levels of bone strontium in dialysis patients being related to osteomalacia.
Oral bioavailability is about 25% strontium ranelate.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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