Etidronate
Brand names Didronel, Didronel PMO
Used in the following combined preparations None
General Information
Etidronate is given for the treatment of bone disorders such as Paget’s disease, it acts only on the bones, reducing the activity of the bone cells and thereby stopping the progress of the disease. This action also stops calcium from being released from the bones into the bloodstream, so it reduces the amount of calcium in the blood. Etidronate is also used together with calcium tablets to treat osteoporosis.
Information for Users
Generally, the drug’s side effects are mild. The most common is diarrhoea, which is more likely to occur with higher doses. If taken at high doses (20mg/kg body weight daily), the drug stops new bone from being formed properly, which can lead to thinning of the bones and fractures. For this reason, high doses must be carefully monitored and used for as short a time as possible. The effect is reversed on stopping the drug.
Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.
How taken
Tablets.
Frequency and timing of doses
Once daily on an empty stomach, 2 hours before or after food.
Dosage range
Paget’s disease 5-20mg/kg body weight daily for a maximum of 3-6 months. There may be repeated cycles. Osteoporosis 400mg daily for 2 weeks, repeated every 3 months.
Onset of effect
Paget’s disease/osteoporosis Beneficial effects may not be felt for several months.
Duration of action
Some effects may persist for several weeks or months.
Diet advice
Absorption of etidronate is reduced by foods, especially those containing calcium (e.g., dairy products), so the drug should be taken on an empty stomach. The diet must contain adequate calcium and vitamin D; supplements may be given.
Storage
Keep in a closed container in a cool, dry place out of the reach of children. Protect from light.
Missed dose
Take as soon as you remember. If your next dose is due within 6 hours, take a single dose now and skip the next.
Stopping the drug
Do not stop the drug without consulting your doctor. Stopping the drug may lead to worsening of the underlying condition.
Exceeding the dose
An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause numbness and muscle spasm. Notify your doctor.
Possible Adverse Effects
The most common side effect, diarrhoea, is disease, bone pain may be increased initially, more likely if the dose is increased above but this symptom usually disappears with 5mg/kg daily. In some patients with Paget’s further treatment.
Interactions
Antacids and iron Antacids or iron should be given at least 2 hours before or after etidronate to minimize effects on absorption.
QUICK REFERENCE
Drug group Drug for bone disorders
Overdose danger rating Medium
Dependence rating Low
Prescription needed Yes
Available as generic No
SPECIAL PRECAUTIONS
Be sure to tell your doctor if:
You have a long-term kidney problem.
You have had a previous allergic reaction to etidronate or other bisphosphonates
You have colitis.
You are taking other medications.
Pregnancy
Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
Safety in breast-feeding not established. Discuss with your doctor.
Infants and children
Not recommended.
Over 60
No special problems.
Driving and hazardous work
No special problems.
Alcohol
No special problems.
PROLONGED USE
Courses of treatment longer than 3 to 6 months are not usually prescribed, but repeat courses may be required. Continuous use of etidronate is not recommended because it may lead to an increased risk of bone fractures.
Monitoring Blood and urine tests may be carried out.
