Etidronate disodium

Generic Medicine Info
Indications and Dosage
Treatment and prophylaxis of ectopic ossification complicating hip replacement
Adult: 20 mg/kg daily 1 mth before and 3 mth after the operation. For ectopic ossification due to spinal cord injury: 20 mg/kg daily for 2 wk followed by 10 mg/kg daily for 10 wk.

Paget's disease of bone
Adult: Initially, 5 mg/kg daily for up to 6 mth. In severe cases, may give up to 10 mg/kg daily for up to 3 mth. Further treatment should only be given after a drug-free interval of at least 3 mth and after evidence of relapse. Subsequent treatment period should not exceed initial treatment period. Max: 20 mg/kg/day.
Overt osteomalacia; abnormalities of the oesophagus (e.g. stricture, achalasia) which may delay oesophagaeal emptying.
Special Precautions
Patient w/ enterocolitis. Renal impairment. Pregnancy and lactation.
Adverse Reactions
Paraesthesia, peripheral neuropathy, confusion, amnesia, depression, hallucination; bone/joint/muscle pain, bone fracture, GI irritation, osteonecrosis of the jaw. Rarely, burning sensation of tongue, alopecia, erythema multiforme, exacerbation of asthma, agranulocytosis or pancytopenia.
Patient Counseling Information
Maintain adequate intake of Ca and vit D, good oral hygiene.
Monitoring Parameters
Monitor alkaline phosphatase and serum Ca levels. Perform routine dental check up.
Symptoms: Hypocalcaemia, vomiting, paraesthesias of the fingers, diarrhoea, electrolyte imbalance. Management: Employ gastric lavage for acute overdosage. Parenteral admin of Ca salt (e.g. IV Ca gluconate) may be given to relieve signs and symptoms of hypocalcaemia.
Drug Interactions
May increase prothrombin time w/ warfarin. May enhance the adverse effects of deferasirox. Decreased serum concentration w/ antacids, multivitamins/minerals. Increased hypocalcaemic effect w/ aminoglycosides. Increased adverse/toxic effect w/ NSAIDs, systemic angiogenesis inhibitors. Diminished therapeutic effect w/ PPIs.
Food Interaction
Food may reduce absorption.
Lab Interference
May interfere w/ diagnostic imaging agents (e.g. technetium-99m-diphosphonate) in bone scans.
Mechanism of Action: Etidronate disodium decreases bone resorption by inhibiting the growth and dissolution of hydroxyapatite crystals in bone and may also directly impair osteoclast activity.
Onset: 1-3 mth.
Duration: Approx 12 mth w/o continuous therapy.
Absorption: Variable and dose dependent (approx 1-6%). Reduced absorption w/ food.
Distribution: Almost exclusively distributed into bone (approx 50% of absorbed amount).
Metabolism: Not metabolised.
Excretion: Via urine, approx 50%. Elimination half-life: 1-6 hr.
Chemical Structure

Chemical Structure Image
Etidronate disodium

Source: National Center for Biotechnology Information. PubChem Database. Etidronate disodium, CID=23894, (accessed on Jan. 23, 2020)

Store below 40°C.
MIMS Class
Agents Affecting Bone Metabolism
ATC Classification
M05BA01 - etidronic acid ; Belongs to the class of bisphosphonates. Used in the treatment of bone diseases.
Anon. Etidronate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 27/08/2015.

Buckingham R (ed). Etidronate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 27/08/2015.

Etidronate Disodium Tablet (Mylan Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. Accessed 27/08/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Etidronate Disodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). Accessed 27/08/2015.

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