Class: Supportive care

Generic Name: Etidronate (eh-TI-droe-nate)
Trade Name: Didronel®

For which conditions is this drug approved? Etidronate is FDA-approved for the treatment of hypercalcemia (high levels of calcium in the blood) caused by cancer.  It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Bone is in a constant state of remodeling in which old bone is removed by cells called osteoclasts (referred to as resorption) and new bone is laid down by cells called osteoblasts. Sometimes, patients with cancer have excessive resorption, leading to high levels of calcium in the blood. Etidronate helps prevent hypercalcemia by inhibiting excessive bone resorption.

How is etidronate typically given (administered)? Etidronate is given orally, in the form of a tablet, or may be given intravenously (into a vein) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.

How are patients typically monitored? Patients may have their blood taken to measure levels of calcium or other minerals or electrolytes, as well as to measure function of the kidneys or other organs.

What are the most common side effects of treatment with etidronate?

• Fever
• Diarrhea
• Nausea
• Changes in the levels of kidney function, as determined by blood tests

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Take tablets on an empty stomach. Avoid foods or supplements that contain calcium, iron or magnesium within 2 hours of taking etidronate.

When should patients notify their physician?

• Sudden weight gain
• Swelling of the ankles or feet
• Little or no urine output
• Signs of hypercalcemia – muscle twitching, frequent urination, loss of appetite, nausea or vomiting, constipation, weakness or fatigue, muscle, confusion, and coma.
• Severe pain
• Allergic reaction (rash, hives, fever, swelling of throat, tongue, lips)

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2010 CancerConnect Last updated 07/10.

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