Paget's disease of bone
Adult: >18 yr: 400 mg once daily for 3 mth, repeat if needed after an interval of at least 3-6 mth.
Indications and Dosage
Oral
Paget's disease of bone Adult: >18 yr: 400 mg once daily for 3 mth, repeat if needed after an interval of at least 3-6 mth.
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Renal Impairment
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Contraindications
Severe renal impairment; pregnancy.
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Special Precautions
Acute upper GI inflammation. Take with plenty of water, at least 2 hr before or after meals.
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Adverse Reactions
Dysphagia, nausea, vomiting, diarrhoea or constipation, asthenia, dizziness, headache, skin reactions, hypocalcaemia, hypophosphataemia, musculoskeletal pain, osteonecrosis of the jaw, ocular disturbances, oesophagitis, oesophageal and gastric ulcer.
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Overdosage
Hypocalcaemia, acute renal failure. Treatment is supportive and symptomatic. Milk or antacids may be given to minimise absorption for oral overdosage. Dialysis unlikely to be helpful.
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Drug Interactions
Bioavailability increased by indometacin when taken at same time. Increased risk of hypocalcaemia with aminoglycosides. Decreased bioavailability when aspirin taken 2 hr after tiludronic acid. Absorption reduced by antacids, calcium salts, magnesium-containing laxatives and iron.
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Food Interaction
Avoid food (particularly calcium-containing products) for 2 hr before and after tiludronic acid.
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Action
Description:
Mechanism of Action: Tiludronic acid inhibits bone resorption. It also prevents formation and dissolution of hydroxyapatite crystals, therefore may interfere with bone mineralisation. Pharmacokinetics: Absorption: Poorly absorbed from GI tract. Oral bioavailability: 6% (fasting). Distribution: Protein-binding: 90%, mostly to albumin. Metabolism: Not metabolised. Excretion: Half excreted in urine; remainder sequestered to bone. |
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Storage
Store at 15-30°C (59-86°F).
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MIMS Class
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