Prevention of skeletal related events (pathological fractures, spinal compression, radiation or surgery to bone or tumour-induced hypercalcemia) in adult patients w/ advanced malignancies involving bone. Treatment of tumour-induced hypercalcaemia (TIH).
Adult & older patientPrevention of skeletal related events in patient w/ advanced malignancies involving bone 4 mg every 3-4 wk. Treatment of TIH Albumin-corrected serum Ca ≥12 mg/dL or 3 mmol/L 4 mg as a single dose.
Ensure patient is adequately hydrated. Avoid overhydration in patients at risk of cardiac failure. Monitor standard hypercalcaemia-related metabolic parameters eg, serum levels of Ca, phosphate & Mg; untreated hypercalcaemia patients w/ some degree of renal function impairment. Do not use concomitantly w/ other bisphosphonate.
May cause lower serum Ca levels w/ aminoglycosides. Possibility of developing hypomagnesaemia w/ other potentially nephrotoxic medicines. Risk of renal dysfunction w/ thalidomide in multiple myeloma patients. Increased incidence of ONJ w/ anti-angiogenic medicines.
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