1,600 mg daily as a single dose. Dose exceeding 1,600 mg must be taken separately (as a 2nd dose). Hypercalcemia 2,400-3,200 mg daily, may be reduced to 1,600 mg daily if applicable. Osteolysis Initially 1,600 mg daily, may be increased to a max of 3,200 mg daily if necessary. Renal insufficiency CrCl 50-80 mL/min 1,600 mg daily, 30-50 mL/min 1,200 mg daily, <30 mL/min 800 mg daily.
View Bonefos overdosage for action to be taken in the event of an overdose.
Administration
Should be taken on an empty stomach: Take at least 1 hr before or 2 hr after food/drinks/other oral medications. Swallow whole w/ a glass of plain water, do not chew/crush.
Contraindications
Hypersensitivity. Concomitant treatment w/ other bisphosphonates.
Maintain adequate fluid intake during treatment. Reports of osteonecrosis of the jaw; atypical subtrochanteric & diaphyseal femoral fractures. Consider preventive dentistry prior to therapy in patients w/ concomitant risk factors (eg, cancer, chemotherapy, radiotherapy, corticosteroids, poor dental hygiene). Consider discontinuation in case of atypical femur fracture. Evaluate patients presenting w/ any thigh, hip or groin pain for an incomplete femur fracture. Renal failure. Pregnancy & lactation.
Risk of renal dysfunction w/ NSAIDs, especially diclofenac. Increased risk of hypocalcemia w/ aminoglycosides. Increased serum conc of estramustine phosphate. Formation of poorly soluble complexes w/ divalent cations (eg, antacids or Fe prep).
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