Chemical Name
Etidronate
 
Ingredients
Active Ingredients: Etidronate

Non-Active Ingredients:
Tablets: magnesium stearate, microcrystalline cellulose, and starch.

Indications
Didronel is used to treat Paget's disease of the bones and in the prevention and treatment of Heterotopic Ossification due to spinal cord injury, or following hip replacement surgery. Didronel is not approved for the treatment of osteoporosis.
Didronel is used to reduce bone pain and hypercalcemia of malignancy (high calcium levels), associated with metastatic breast cancer, multiple myeloma and prostate cancer.

How It Works
Etidronate is part of a group of medicines called bisphosphonates. It alters the speed and cycle of bone formation and breakdown in the body. It also decreases pain in cancer patients bones due to excessive levels of calcium being used to prevent bone and bone marrow deterioration.

Dosage
Tablets (200mg)

The normal oral dosage (tablets) of Didronel is 400 mg/day, taken as a single dose or divided in two doses. Didronel can be taken at any time of the day as long as it is taken at the same time everyday. Didronel should be taken 2 hours before or 2 hours after eating. Food can affect the rate of absorption of the drug, especially food high in calcium, such as milk or milk products or vitamins with mineral supplements or antacids which are high in metals such as calcium, iron, magnesium, or aluminum.
Treatment for Paget's Disease should not to exceed 6 months, if re-treatment is necessary it should only occur after 3 months off of the drug, and if there is evidence that the disease is still active.

Treatment for Heterotopic Ossification: Total Hip Replacement Patients: should take Didronel 1 month before and 3 months after surgery (4 months total). Spinal Cord Injured Patients: treatment should last a maximum of 12 weeks. Didronel therapy should begin as soon as possible following an injury, preferably prior to evidence of heterotopic ossification.

Precautions
Didronel is contraindicated in patients with a hypersensitivity to etidronate or a condition called osteomalacia (softening of the bones). Make sure your doctor knows your medical history, especially if you have any history of kidney disease, bone marrow depression, diarrhea, a bone fracture, a stomach or esophageal ulcer disease. If you suffer from any of these conditions then you may not be able to take Didronel or you may require special dosage instructions.

You should consult a doctor before using this medication if you are allergic to etidronate or similar medicines, or any of the other ingredients of Didronel.

In rare cases some people have developed bone loss in the jaw, called osteonecrosis of the jaw. Symptoms of this condition include jaw pain, loose teeth, swelling, gum infection, numbness, or slow healing after injury or surgery involving the gums. You are more likely to develop osteonecrosis of the jaw if you have cancer or have been treated by chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include anemia (low red blood cells), blood clotting disorders, and dental problems.

It is unknown whether this medicine can cause harm to an unborn baby and you should not take this medication before telling your doctor if you are pregnant or plan to become pregnant during treatment. Didronel may pass into breast milk and may causes harm to a nursing baby, consult your doctor before using this medication if you are pregnant or breast-feeding a baby.

Didronel may cause drowsiness or dizziness. Do not drive, operate heavy machinery, or perform dangerous tasks until you know how you react. Using Didronel with alcohol may increase the effects of alcohol use caution.

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Drug Interactions
Before taking Etidronate, tell your doctor if you are on any type of blood thinner such as Warfarin (coumadin). You should avoid taking aspirin or non-steroidal anti-inflammatory drugs (NSAIDs such as Ibuprofen, or Naproxen) that could also cause stomach irritation/ulcers. Ask your pharmacist about using these products safely. If you are taking low doses of aspirin to prevent heart attack or stroke, you should probably continue to take the aspirin. You can consult with your doctor or pharmacist.

Before using this Didronel, tell your doctor or pharmacist about all prescription and nonprescription medications, including herbal products, minerals and vitamins you may be taking. Antacids and multivitamins that usually contain minerals such as calcium, magnesium, iron, or aluminum will affect the rate at which Didronel is absorbed.
Other medications may affect how Didronel works or may cause other unforeseen complications.

Didronel is usually prescribed with vitamins and supplements such as calcium and vitamin D pills. Always consult your doctor and make sure that taking other vitamins and supplements is the right thing to do for your particular condition.

Adverse/Side Effects
It is common that Didronel may cause some of the following minor side effects: mild diarrhea, headache, confusion, nausea or numbness or tingly feeling. If these side effects persist or become overly bothersome contact your doctor or health-care professional.

If you are experiencing any of the following severe side effects you stop using Didronel and you should contact your doctor immediately. Severe side effects include: severe joint, bone, or muscle pain, jaw pain, numbness, or swelling, mental/mood changes, severe diarrhea, bone fracture, signs of infection or a blistering, red, peeling skin rash.

This medication may sometimes cause ulcers and irritation in your stomach or esophagus. Seek immediate medical attention if any of these serious side effects occur: chest pain, new/severe/worsening heartburn, difficult/painful swallowing, black/tarry stools, severe stomach/abdominal pain, or vomit that looks like coffee grounds.

In rare cases some people have also developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition include jaw pain, loose teeth, swelling, gum infection, numbness, or slow healing after injury or surgery involving the gums. You are more likely to develop osteonecrosis of the jaw if you have cancer or have been treated by chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include anemia (low red blood cells), blood clotting disorders, and dental problems.

If any of these side effects are worrisome seek medical attention immediately. A very serious allergic reaction to this drug is rare. Get emergency medical help if you have any of these signs of an allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing. This may not be a complete list of side effects and may be subject to change, consult with your doctor or pharmacist if you are experiencing any worrisome side effects.

Overdose
If you suspect overdose, contact your local poison control center or emergency room immediately. Symptoms of overdose include severe nausea and muscle spasms, mental/mood changes.

Storage Instructions
Store at room temperature, store away from sunlight and moisture and keep out of the reach of children and pets.

 

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