Clodronic Acid; Indications/Uses, Side Effects, Interactions, Pragnancy

• Hypercalcemia of Malignancy
• Osteolytic Bone metastases
• For the management of hypercalcemia of malignancy and as an adjunct in the management of osteolysis resulting from bone metastases of malignant tumors.

Contra-Indications of Clodronic Acid

• Hypersensitivity to ibandronic acid or to any of the excipients.
• Hypocalcemia
• Abnormalities of the esophagus which delay oesophageal emptyings such as stricture or achalasia
• Acute inflammations of the gastrointestinal tract (esophagitis, gastritis, ulcerations)
• Clinically manifest osteomalacia
• Certain malformations and malfunctions of the esophagus (strictures, achalasia)
• Inability to stand, walk, or sit for 30 minutes after oral administration
• Renal impairment with a creatinine clearance below 30ml/min
• Patients below 18 yrs. of age, as no clinical data exists
• Signs of colic, which is usually self-limiting, occurs in 30-45% of horses.
• Electrolyte disturbances – primarily calcium, magnesium, and potassium, which can last for several hours. Caution should be used in horses with disease processes that could be affected by electrolyte disturbances, such as hyperkalemic periodic paralysis or cardiac disease.
• Kidney damage – it is eliminated by the kidney and is not recommended for use in animals with impaired renal function.
• Less serious reactions include stiffness of the neck, decreased appetite, fever, and increased urination.
• Inability to stand, walk, or sit for 30 minutes after oral administration
• Renal impairment with a creatinine clearance below 30ml/min
• Hypocalcemia
• Pregnancy and breastfeeding

The dosage of Clodronic Acid

Strengths: 300 mg, 600 mg ,1600 mg, 3200 mg

Osteolytic bone metastases 

• Initial: 1,600 mg/day, increase as needed. Max: 3,200 mg/day.
• Hypercalcemia of malignancy Maintenance following IV therapy: 1,600-2,400 mg/day. Max: 3,200 mg/day.
• IV Hypercalcaemia of malignancy 300 mg/day for up to 7 days, or 1,500 mg as a single infusion

Hypercalcaemia of malignancy

• 300 mg daily via infusion over at least 2 hr until normocalcaemia is achieved. Max duration of treatment: 7 days. Alternatively, 1,500 mg as a single infusion over at least 4 hr.

Osteolytic bone metastases

• Initially, 1,600 mg daily as a single or in 2 divided doses, increased as necessary. Max: 3,200 mg daily.

Hypercalcaemia of malignancy

• Maintenance following Ca normalization w/ IV therapy: 1,600-2,400 mg as a single or in 2 divided doses. Max: 3,200 mg daily.

Side Effects of Clodronic Acid

• Heartburn
• The most commonrn (a burning feeling in the chest, behind the breastbone or gullet)
• Abdominal or stomach pain
• pain, warmth and/or swelling in a leg or in the pelvis
• sudden tingling or coldness in an arm or leg
• Burning, itching, stinging, redness, or other sign of irritation at the application site , rash
• Indigestion
• Constipation
• High blood pressure
• Nausea, vomiting,
• painful or swollen gums
• numbness or heavy feeling in the jaw
• dull, aching pain in the hip, groin, or thigh
• liver problems,
• stomach pain,
• Dizziness
• a headache,
• reversible hair loss or thinning, and
• fever.

Common

• chills or fever
• headache, severe and throbbing
• joint or back pain
• muscle aching or cramping
• muscle pains or stiffness
• chest pressure or squeezing pain in chest
• excessive sweating
• sudden drowsiness or need to sleep
• sharp pain when taking a deep breath
• coughing up blood
• rust colored urine
• liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
• decreased amount of urine

Rare

• Anxiety
• change in vision
• chest pain or tightness
• confusion
• cough
• Agitation
• arm, back, or jaw pain
• blurred vision
• chest pain or discomfort
• convulsions
• extra heartbeats
• hallucinations
• headache
• irritability
• lightheadedness
• muscle pain or cramps
• muscle spasm or jerking of all extremities
• severe pain in your upper stomach spreading to your back, nausea, and vomiting;