Hypercalcemia of malignancy (HCM), multiple myeloma, bone metastases from solid tumors (including prostate cancer, breast cancer, lung cancer, renal cell carcinoma, other solid tumors) in combination w/ standard antineoplastic therapy to prevent or delay potential complications from bone lesions.
IV infusionHypercalcemia of malignancy [albumin-corrected serum Ca >12 mg/dL (3 mmol/L)] 4 mg as single dose over not <15 min following standard rehydration procedures. Bone metastases of solid tumors & osteolytic lesions of multiple myeloma (for patient w/ CrCl >60 mL/min) 4 mg as single dose over not <15 min every 3-4 wk. Patients w/ CrCl 50-60 mL/min 3.5 mg given every 3-4 wk. 40-49 mL/min 3.3 mg given every 3-4 wk. 30-39 mL/min 3 mg given every 3-4 wk.
Monitor serum levels of Ca, phosphate & Mg after initiating therapy. Evaluate serum creatinine conc prior to therapy. Hydration & electrolyte monitoring. Renal impairment; musculoskeletal pain; osteonecrosis of the jaw; atypical fractures of the femur; asthma. Discontinue use if ocular disturbances occur. May impair ability to drive or operate machinery. Hepatic impairment. Childn 1-17 yr. Elderly.
Increased risk of hypocalcemia w/ loop diuretics. Possible additive effect in lowering serum Ca conc for prolonged periods w/ aminoglycosides. Increased risk of renal impairment w/ nephrotoxic drug (eg, other antineoplastic agents, ASA, NSAIDs) or drugs that significantly impact renal function (eg diuretics, ACE inhibitors). Increased risk of renal insufficiency w/ thalidomide (especially in patients w/ multiple myeloma).
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