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etidronate

Generic Name: etidronate (e ti DROE nate)
Brand Name: Didronel, Didronel I.V.

What is etidronate?

Etidronate is in a group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body.

Etidronate is used to treat Paget's disease, and to treat conditions of irregular bone growth due to hip fracture or spinal cord injury.

Etidronate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about etidronate?

You should not take this medicine if you have a condition called osteomalacia (softening of the bones), or a problem with the movement of muscles in your esophagus.

What should I discuss with my healthcare provider before taking etidronate?

You should not take this medicine if you have a condition called osteomalacia (softening of the bones), or a problem with the movement of muscles in your esophagus.

To make sure etidronate is safe for you, tell your doctor if you have:

  • diarrhea;

  • a bone fracture;

  • trouble swallowing;

  • a stomach or esophageal ulcer or disease; or

  • kidney disease.

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use etidronate, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre existing dental problem.

Talk with your doctor about the risks and benefits of using this medication.

It is not known whether etidronate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether etidronate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take etidronate?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or suck the pill. Swallow it whole.

Take each etidronate tablet with a full glass (6 to 8 ounces) of water. Use only plain water (not mineral water) when taking an etidronate tablet.

For at least the first 2 hours after taking etidronate, do not eat or drink anything other than plain water, and do not take any other medicines including vitamins or mineral supplements.

It is important to take etidronate regularly to get the most benefit.

If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using etidronate. You may need to stop using the medicine for a short time.

After you stop taking etidronate, you must stay off the medication for at least 90 days before starting etidronate therapy again.

Your doctor will need to check your progress while you are using etidronate.

Etidronate is only part of a complete program of treatment that may also include taking calcium and vitamin supplements. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes.

What should I avoid while taking etidronate?

Avoid drinking milk or eating dairy products within 2 hours after taking etidronate. Also avoid taking supplements that contain calcium, magnesium, iron, or aluminum (such as in multivitamins with iron, and in many types of antacids).

Etidronate side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using etidronate and call your doctor at once if you have:

  • painful or difficult swallowing;

  • severe heartburn, burning pain in your upper stomach, or coughing up blood;

  • severe joint, bone, or muscle pain;

  • jaw pain, numbness, or swelling;

  • severe diarrhea; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • mild diarrhea;

  • headache, confusion;

  • muscle cramps, joint pain; or

  • numbness or tingly feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Etidronate dosing information

Usual Adult Dose for Paget's Disease:

Initial Treatment Regimens:
-5 to 10 mg/kg/day orally once a day, not to exceed 6 months, or
-11 to 20 mg/kg/day orally once a day, not to exceed 3 months

Comments:
-Doses above 10 mg/kg/day should be reserved for when lower doses are ineffective, or if there is an overriding need to suppress rapid bone turnover (especially when irreversible neurologic damage is possible), or to reduce elevated cardiac output.
-Doses above 20 mg/kg/day are not recommended.

Retreatment Guidelines:
-Retreatment should be initiated only after: A drug-free period of at least 90 days; and when there is biochemical, symptomatic, or other evidence of active disease process.
-Patients should be monitored every 3 to 6 months, although some patients may go drug free for extended periods.
-Retreatment regimens are the same as for initial treatment. For most patients the original dose will be adequate. If not, consider increasing the dose within the recommended guidelines.

Comments:
-Response to therapy may be of slow onset and may continue for months after therapy with this drug is discontinued. In some patients, the disease process will be suppressed for at least one year, or more, following cessation of therapy.
-Dosage should not be increased prematurely nor should treatment be resumed before there is clear evidence of reactivation of the disease process.
-Patients should adhere to the recommended dose regimen to avoid over- treatment with this drug.

Uses:
-Treatment of symptomatic Paget's disease of bone
-The effects of this drug in patients with asymptomatic Paget's disease have not been studied; however, treatment may be warranted if extensive involvement threatens irreversible neurologic damage, major joints, or major weight-bearing bones.

Usual Adult Dose for Heterotopic Ossification -- Spinal Cord Injury:

Total Hip Replacement:
-20 mg/kg/day orally once a day, for 1 month before and 3 months after surgery (4 months total).

Spinal Cord Injury:
-20 mg/kg/day orally once a day, for 2 weeks followed by 10 mg/kg/day for 10 weeks (12 weeks total).

Comment:
-Therapy should begin as soon as medically feasible following the injury, preferably prior to evidence of heterotopic ossification.
-Retreatment has not been studied.
-In total hip replacement patients, this drug does not promote loosening of the prosthesis or impede trochanteric reattachment.
-In spinal cord injury patients, this drug does not inhibit fracture healing or stabilization of the spine.

Uses: Prevention and treatment of heterotopic ossification following total hip replacement or due to spinal cord injury.

Usual Adult Dose for Heterotopic Ossification -- Total Hip Arthroplasty:

Total Hip Replacement:
-20 mg/kg/day orally once a day, for 1 month before and 3 months after surgery (4 months total).

Spinal Cord Injury:
-20 mg/kg/day orally once a day, for 2 weeks followed by 10 mg/kg/day for 10 weeks (12 weeks total).

Comment:
-Therapy should begin as soon as medically feasible following the injury, preferably prior to evidence of heterotopic ossification.
-Retreatment has not been studied.
-In total hip replacement patients, this drug does not promote loosening of the prosthesis or impede trochanteric reattachment.
-In spinal cord injury patients, this drug does not inhibit fracture healing or stabilization of the spine.

Uses: Prevention and treatment of heterotopic ossification following total hip replacement or due to spinal cord injury.

What other drugs will affect etidronate?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • a blood thinner--warfarin, Coumadin, Jantoven.

This list is not complete. Other drugs may interact with etidronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about etidronate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.04. Revision Date: 2015-09-22, 3:33:26 PM.

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