Treatment of hypercalcemia of malignancy (HCM). Prevention of skeletal related events (pathological fractures, spinal compression, radiation or surgery to bone, or tumor induced hypercalcemia) in patients w/ advanced malignancies involving bone.
IV infusionPrevention of skeletal related events in patients w/ advanced malignancies involving boneAdult & Elderly 4 mg every 3-4 wk. Patients should also be administered an oral Ca supplement 500 mg & vit D 400 IU daily. Mild to moderate renal impairment CrCl >60 mL/min 4 mg/100 mL, CrCl 50-60 mL/min 3.5 mg/100 mL, CrCl 40-49 mL/min 3.3 mg/100 mL, CrCl 30-39 mL/min 3 mg/100 mL. Hypercalcemia of malignancy (HCM) Adult & Elderly Single 4 mg infusion.
Consider discontinuation of treatment in patients suspected to have an atypical femur fracture. Avoid overhydration in patients at risk of cardiac failure. Monitor serum albumin-corrected levels of Ca, phosphate, Mg, serum creatinine; renal function. Not to be given w/ other bisphosphonates. Patients should maintain good oral hygiene & should have a dental exam w/ preventive dentistry prior to treatment. Avoid invasive dental procedures. Osteonecrosis of other anatomical sites. Musculoskeletal pain. Synergistic effect w/ other hypocalcemia causing drugs. Not recommended in severe renal impairment. Hepatic impairment. Women of child-bearing potential should avoid becoming pregnant. Not to be used during pregnancy & breast-feeding women.
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