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Etidronate

    Brands

    DEA Class; Rx

    Common Brand Names; Didronel

    • Calcium Metabolism Modifiers; 
    • Bisphosphonate Derivatives

    Injectable and oral first-generation bisphosphonate with a lower potency and selectivity vs. newer second- and third-generation bisphosphonates
    For Paget’s disease the drug has largely been replaced by newer bisphosphonates that are easier to use and have greater antiresorptive potency; also indicated for heterotopic ossification but treatment is costly
    Not recommended by guidelines for osteoporosis treatment or prevention as lacks efficacy data proving fracture reduction

    Indicated for the treatment of moderate to severe Paget’s disease.
    For the prevention and treatment of heterotopic ossification.
    For the treatment of hypercalcemia associated with malignant neoplasms.

    Osteomalacia

    Hypersensitivity

    Esophagus abnormalities (eg, stricture, achalasia) that delay esophageal emptying

    • Convulsion
    • Fever
    • Hypocalcemia
    • Hypomagnesemia
    • Hypophosphatemia
    • Bone pain
    • Abnormal renal function
    • Amnesia
    • Confusion
    • Depression
    • Hallucination
    • Headache
    • Paresthesias
    • Alopecia
    • Rash
    • Altered taste
    • Gastritis
    • Glossitis
    • Hypocalcemia
    • Hypersensitivity reactions
    • Arthropathy
    • Fracture
    • Leg cramps
    • Nephrotoxicity
    • Renal insufficiency

    Enterocolitis, renal impairment

    May cause local irritation of upper GI mucosa

    Potentially causes severe esophagitis, esophageal ulcers and erosions

    Ensure adequate intake of calcium, vitamin D

    Osteonecrosis of the jaw, can occur spontaneously and is generally associated with tooth extraction and/or local infection with delayed healing; known risk factors include invasive dental procedures (e.g., tooth extraction, dental implants, boney surgery), diagnosis of cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders; risk of osteonecrosis of the jaw may increase with duration of exposure to bisphosphonates

    Risk of severe bone, joint and/or muscle pain

    At higher doses both resorption inhibition and bone growth inhibition increases

    Pregnancy Category: C

    Lactation: excretion in milk unknown; use with caution

    Adults

    20 mg/kg/day PO.

    Elderly

    20 mg/kg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Etidronate disodium

    tablet

    • 200mg
    • 400mg