Hypercalcemia of malignancy. Prevention of skeletal-related events (pathological fractures, spinal compression, bone radiation or surgery, or tumour-induced hypercalcaemia) in patients w/ advanced bone malignancies.
Adult & elderlyTumour-induced hypercalcaemia 4 mg single dose.Prevention of skeletal-related events in patient w/ advanced bone malignancies4 mg every 3-4 wk.
Osteonecrosis of the jaw (ONJ) & external auditory canal; bone, joint &/or muscle pain; atypical subtrochanteric & diaphyseal femoral fractures. Avoid overhydration in patients at risk of cardiac failure. Correct hypocalcaemia prior to therapy. Adequate Ca & vit D supplementation during therapy. Monitor standard hypercalcaemia-related metabolic parameters eg, serum Ca, phosphate, Mg & creatinine levels during therapy. Perform dental exam w/ appropriate preventive dentistry prior to therapy. Avoid invasive dental procedures & maintain good oral hygiene during treatment. Ensure adequate hydration prior to & following administration. Concomitant use w/ nephrotoxic drugs; medicines causing hypocalcaemia. May affect ability to drive & use machines. Not recommended in severe renal impairment. Hepatic impairment. Avoid pregnancy in women of childbearing potential. Not to be used during pregnancy. Childn 1-17 yr.