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Indications

REMS

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: arrhythmias, hypertension, syncope, tachycardia.

EENT: blurred vision, conjunctivitis, eye pain/inflammation, rhinitis.

Endo: hypothyroidism.

F and E: hypocalcemia, hypokalemia, hypomagnesemia, hypophosphatemia, fluid overload.

GI: nausea, abdominal pain, anorexia, constipation, vomiting.

GU: nephrotoxicity.

Hemat: leukopenia, anemia.

Local: phlebitis at injection site.

MS: muscle stiffness, pain, femur fractures, osteonecrosis (primarily of jaw).

Neuro: fatigue.

Resp: rales.
Misc: fever.

Interactions

Drug-Drug:

Availability

(Generic available)

Route/Dosage

Hypercalcemia of Malignancy

Osteolytic Lesions from Multiple Myeloma

Osteolytic Lesions from Metastatic Breast Cancer

Paget’s Disease

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: bone resorption inhibitors

Pharmacologic Classification: hypocalcemics

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Rapidly absorbed by bone. Reaches high concentrations in bone, liver, spleen, teeth, and tracheal cartilage. Approximately 50% of a dose is retained by bone and then slowly released.

Metabolism/Excretion: 50% is excreted unchanged in the urine.

Half-life: Elimination half-life from plasma is biphasic — 1st phase 1.6 hr, 2nd phase 27.2 hr. Elimination half-life from bone is 300 days.

Time/Action Profile

(effect on serum calcium)

ROUTEONSETPEAKDURATION
IV24 hr7 daysunknown

Patient/Family Teaching

Pronunciation

pa-MID-roe-nate