Bonefos

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CLODRONATE (Systemic)*

Some commonly used brand names are:

In Canada—

  • Bonefos

Another commonly used name is disodium clodronate .

* Not commercially available in the U.S.

Category

  • Bone resorption inhibitor, treatment for bone weakening
  • Antihypercalcemic agent, reduces high blood calcium levels caused by cancer

Description

Clodronate (KLA-dro-nayt)is a medicine used to treat a high level of calcium in the blood caused by changes in the body that happen with cancer. Clodronate also treats the weakening in the bones when cancer has spread to the bones from another part of the body.

This medicine is available only with your doctor"s prescription, in the following dosage forms:

  • Oral
  • Capsules (Canada)
  • Parenteral
  • Injection (Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clodronate, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to clodronate. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Clodronate has not been studied in pregnant women. However, studies in animals have shown that clodronate causes birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding— It is not known whether clodronate passes into human breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of clodronate in children with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of clodronate in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clodronate, it is especially important that your health care professional know if you are taking any of the following:

  • Antacids (e.g., Maalox, Mylanta) or
  • Calcium supplements (e.g., Tums) or
  • Iron supplements (e.g., Geritol)—Taking these medicines and also taking clodronate may cause the clodronate to not work as well
  • Calcitonin (e.g., Calcimar, Miacalcin) or
  • Corticosteroids (e.g., Prednisone) or
  • Loop diuretics (e.g., Lasix, Demadex) or
  • Mithramycin (e.g., Mithracin) or
  • Phosphate (e.g., found in Centrum, Ensure)—Taking these medicines and also taking clodronate may cause the calcium in your blood to be too low

Other medical problems—The presence of other medical problems may affect the use of clodronate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Stomach cramping or pain, nausea, stomach burning—Taking clodronate, especially by mouth, may make your stomach problems worse
  • Kidney problems—Taking clodronate may cause your kidney problems to get worse. Your doctor may give you a smaller amount of clodronate to take

Proper Use of This Medicine

Dosing—The dose of clodronate will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of clodronate. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking clodronate.

  • For oral dosage form :
    • For treating hypercalcemia (too much calcium in the blood):
      • Adults—1600 milligrams (mg) to 2400 mg given in one or two divided amounts per day. Your doctor may give you capsules after you have had clodronate through your vein. You should not take more than 3200 mg in a day. You should take clodronate at least two hours before or after food.
      • Children—Use and dosage must be determined by your doctor.
    • For injection dosage form:
    • For treating hypercalcemia (too much calcium in the blood):
      • Adults—300 mg in a solution to be injected over at least two hours into a vein once a day for two to five days. The treatment will not be longer than seven days. The amount of medicine may be less if you have kidney problems.
      • Children—Use and dosage must be determined by your doctor.

Storage—To store this medicine:

  • Keep out of the reach of children. Overdose of clodronate is very dangerous in young children.
  • Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is very important that you take adequate fluid before and while taking clodronate.

If you will be taking this medicine for a long time, it is very important that your doctor see you at regular visits to check the calcium in your blood and to see how well the clodronate is working.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Breathing problems; convulsions (seizures); mood or mental changes; muscle cramps in hands, arms, feet, legs, or face; muscle shaking ; problems with urination; sores in throat; stomach cramps or pain; swelling of face, ankles or hands; unusual heartbeats; unusual tiredness or weakness

Symptoms of Overdose

Get emergency help immediately if any of the following symptoms of overdose occur

Convulsions (seizures); mood or mental changes; muscle cramps; problems with urination; stomach pain or cramps; trouble breathing; unusual heartbeat

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea; increased bowel movements; nausea and vomiting

Less common

Cloudy urine; mouth irritation

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 03/08/2001

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Typical mistypes for Bonefos
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