etidronate (Didronel)
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Introduction
Tradename: Didronel.
Indications
- Paget's disease of the bone
- 5-10 mg/kg/day, do not exceed 6 months
- 11-20 mg/kg/day, do not exceed 3 months
- hypercalcemia of malignancy
- 20 mg/kg/day for 30 days
- continue for another 30 days if needed
- hypertrophic calcification secondary to spinal cord injury
- 20 mg/kg/day for 2 weeks, then
- 10 mg/kg/day for 10 weeks
- total hip replacement (complicated)
- 20 mg/kg/day for 1 month preoperatively
- 20 mg/kg/day for 3 months post-operatively
- osteoporosis: 400 mg PO QD for 2 weeks every 3 months[4]
- of little benefit for primary prevention or secondary prevention of vertebral fractures or femoral fractures[5]
- hypercalcemia:
- doses > 20 mg/kg/day are not recommended
Dosage
Tabs: 200 & 400 mg
Pharmacokinetics
- oral bioavailability is low, take on empty stomach
- not metabolized
elimination via kidney
Adverse effects
- not common (1-10%)
- fever
- fluid overload
- GI complaints
- metabolic disturbances
- bone pain
- uncommon (< 1%)
- occult fecal blood, increased risk of fractures, renal impairment, hypersensitivity, angioedema (rare), convulsions (rare), rash
Drug interactions
- Ca+2 & antacids interfere with absorption
- drug interaction(s) of bisphosphonates with proton pump inhibitors
- drug interaction(s) of bisphosphonate with Ca+2
Mechanism of action
- bisphosphonate
- acts primarily on bone to inhibit resorption
- inhibits osteoclastic activity
More general terms
Additional terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 5.0 5.1 Wells GA, Hsieh SC, Peterson J, et al. Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2024 Apr 9;4(4):CD003376. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38591743 PMCID: PMC11003221 (available on 2025-04-09)
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=23894
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3305
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=123827
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=17572
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=19629
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=26938