This medication is a bisphosphonate, prescribed for Paget's disease (a condition in which the bones are soft and weak and may be deformed, painful, or easily broken), high blood calcium levels (hypercalcemia) that may occur with cancer or multiple myeloma especially when the bone is affected. It works by slowing bone breakdown, increasing bone density (thickness) and decreasing the amount of calcium released from the bones into the blood.
Contraindicated to pregnant women and patients with known hypersensitivity.
Adult: IV- Paget's disease of bone- 30 mg/day for 3 consecutive days.
Hypercalcemia- 60 to 90mg, as single dose, over 2 to 24 hours.
Multiple Myeloma with bone disease- 90 mg administered as a 4-hour infusion given on a monthly basis.
It comes as a solution to inject into a vein, administered by a healthcare provider.
• Do not take calcium and vitamin D supplement if you have high blood calcium levels.
• If possible, avoid dental treatment while you are using this medication to prevent osteonecrosis of the jaw.
• It may increase the risk of heart failure in patients with heart disease.
• Inject slowly to reduce risk of adverse effects (e.g. injection site reactions, kidney impairment).
• ♦Monitor blood counts in patients with preexisting poor blood counts.
Generalized pain, fever, reactivation of viral diseases. Flu-like reaction may occur initially.
• Heart : High blood pressure, abnormal heart rate or rhythm, heart failure, syncope.
• Central Nervous System: Confusion, visual hallucinations, electrolyte imbalance, sleeplessness, nervousness, drowsiness, mental or mood changes.
• Gastrointestinal: Abdominal pain, loss of appetite, constipation, nausea, vomiting, diarrhea, mouth ulcer, gastrointestinal hemorrhage, osteonecrosis of jaw.
• Genitourinary: Increased blood urea, renal tubular disorders (RTD).
• Skin : Rash, itching.
• Eye: Inflammation of eye tissues.
• Blood: Decrease in red blood cells, white blood cells and platelets.
• Metabolic: Low thyroid hormone, decrease in calcium, potassium, magnesium, phosphate level in blood.
♦• Respiratory: Runny nose, upper respiratory infection, adult respiratory distress syndrome (ARDS and interstitial lung disease (ILD).
• Musculoskeletal: Bone and muscle pain
Rare instances of allergic manifestations have been reported, including low blood pressure, difficulty in breathing, or angioedema, and, very rarely, anaphylactic shock.
Potentially Fatal: Acute kidney and heart failure.
Patient may develop bone, muscle pain at anytime after starting this medication.
Injection: Store it at room temperature. After reconstitution: Stable for up to one day when refrigerated at 2-8°C.
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