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Administration
Should be taken on an empty stomach. Take on an empty stomach w/ a glass of plain water at least 1 hr before or after food. Remain in an upright position for at least 30 min. Do not take w/ milk, food or products containing Ca or other polyvalent cations. Tab may be divided only along the score-line. Swallow cap/tab whole or divided halves of tab, do not chew/crush.
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Contraindications
Acute GI inflammatory conditions. Severe renal failure (CrCl <10mL/min). Pregnancy and lactation. Patients receiving other bisphosphonates.
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Special Precautions
Renal impairment. Patient Counselling Maintain adequate fluid intake. Monitoring Parameters Monitor hepatic and renal function, CBC; serum Ca, K, Mg, and phosphate levels.
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Adverse Reactions
Osteonecrosis of the jaw and external auditory canal, skin reactions (e.g. pruritus, urticaria, exfoliative dermatitis), bronchospasm, diarrhoea, nausea, vomiting, moderate leucopenia, renal dysfunction (including renal failure), hypocalcaemia; elevated serum creatinine, lactic acid dehydrogenase, parathyroid hormone, transaminase and alkaline phosphatase; transient proteinuria (IV). Rarely, atypical femoral fractures.
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Drug Interactions
Decreased effect and absorption w/ antacids or iron preparations. Increased risk of severe hypocalcaemia w/ aminoglycosides. Increases serum level of estamustine phosphate. May potentiate the hypocalcaemic effect w/ corticosteroids, phosphate, calcitonin, mithramycin and loop diuretics. Risk of renal dysfunction w/ NSAIDs.
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CIMS Class
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ATC Classification
M05BA02 - clodronic acid ; Belongs to the class of bisphosphonates. Used in the treatment of bone diseases.
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