Included in the formulation
АТХ:M.05.B.A.02 Clodronic acid
Pharmacodynamics:Refers to the group of bisphosphonates, inhibits bone resorption in malignant tumors and bone metastases. It suppresses the activity of osteoclasts, causes damage to their structure, decreases in size and quantity.
Selectively affects the bone tissue. Reduces the severity of pain in osteoporosis and metastatic bone damage. Effectively reduces the level of calcium in the blood plasma, preventing the development of clinical signs of hypercalcemia and hypercalcaemic coma.
In the treatment of osteoporosis, the mass of bone tissue increases by the end of the first year of therapy, especially in the spine. As an alternative to hormone replacement therapy can be used in postmenopausal osteoporosis. When an overdose affects osteoblasts, and the mineralization of bone tissue (osteomalacia) is disturbed.
Pharmacokinetics:After oral administration, up to 2% is absorbed in the gastrointestinal tract. Metabolism in the liver.
The half-life of plasma is 2 hours.The half-life of clodronic acid from bones is long, up to several years. Elimination by the kidneys.
Indications:It is used to treat osteolysis and osteoporosis due to increased bone resorption, with hypercalcemia accompanying malignant tumors. Used to prevent the development of bone metastases in primary breast cancer.
II.C40-C41.C40.9 Malignant neoplasm of bones and articular cartilage of limb, unspecified
II.C50.C50 Malignant neoplasm of breast
II.C76-C80.C79.5 Secondary malignant neoplasm of bone and bone marrow
XIII.M80-M85.M82.0 * Osteoporosis in multiple myelomatosis (C90.0 +)
XIII.M86-M90.M89.5 Osteolysis
Contraindications:Severe renal insufficiency, individual intolerance, children's age (due to lack of clinical experience).
Carefully:Renal failure of moderate severity, Paget's disease.
Pregnancy and lactation:Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.
Dosing and Administration:Infusion of 3-5 mg / kg body weight intravenously drip for 3-5 hours for 2-3 days with a further transition to oral administration:
- with myeloma - 1,6-2,4 g / day;
- for breast cancer - 2.4-3.3 g / day, after clinical improvement - 1.6 g / day;
- with prostate cancer - intravenously drip 3-5 mg / kg for 5 days, then inside at 1.6-3.2 g / day.
The course of treatment with clodronic acid can last from several months to 2 years or more.
The highest daily dose: 3.3 g.
The highest single dose: 3.3 g.
Side effects:Digestive system: nausea, diarrhea, vomiting.
Urinary system: rarely acute renal failure after bolus injection.
Allergic reactions.
Overdose:Hypocalcemia.
Treatment is symptomatic.
Interaction:Simultaneous use of aminoglycosides increases the risk of hypocalcemia.
Drugs containing divalent cations (Ca, Fe, Mn, Mg, etc.), easily form bonds with clodronic acid, so such drugs can not simultaneously take inside.
Special instructions:During treatment, you need to consume enough fluids and restrict the intake of foods that contain calcium.