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 BRAND NAMES
 MECHANISM OF ACTION
Etidronate is a bisphosphonate, it has no direct effect on bone formation, but it stops the action of the osteoclasts, the cells that are involved in breaking down the bone tissue.
Etidronate is internalized by osteoclasts, causing disruption of osteoclast cytoskeleton, loss of the ruffled border, and the subsequent loss of ability to resorb bone.
Etidronate, unlike other bisphosphonates, also prevents bone calcification. For this reason, other bisphosphonates, like alendronate, are preferred when fighting osteoporosis. T
- Paget's disease of bone.
- Heterotopic Ossification: Etidronic acid is indicated in the prevention and treatment of heterotopic ossification following total hip replacement or due to spinal cord injury
Etidronic acid should be taken as a single, oral dose. As with other bisphosphonates, it should be swallowed with a full glass of water. Patients should not lie down after taking the medication. However, should gastrointestinal discomfort occur, the dose may be divided. To maximize absorption, patients should avoid taking the following items within two hours of dosing: Food, especially food high in calcium, such as milk or milk products and Vitamins with mineral supplements or antacids which are high in metals such as calcium, iron, magnesium, or aluminum.
Paget’s Disease: Initial Treatment Regimens: 5 to 10 mg/kg/day, not to exceed 6 months, or 11 to 20 mg/kg/day, not to exceed 3 months.
- Abnormalities of the esophagus which delay esophageal emptying such as stricture or achalasia.
- Known hypersensitivity to etidronate disodium or in patients with clinically overt osteomalacia.
- Etidronic acid may cause local irritation of the upper gastrointestinal mucosa. Caution should be used when Didronel is given to patients with active upper gastrointestinal problems (such as known Barrett’s esophagus, dysphagia, other esophageal diseases, gastritis, duodenitis or ulcers).
- Osteonecrosis of the jaw (ONJ): ONJ, which can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, and has been reported in patients taking bisphosphonates, including Etidronic acid.
- There have been isolated reports of patients experiencing increases in their prothrombin times when etidronate was added to warfarin therapy.
 PREGNANCY AND LACTATION
- Pregnancy Category C (US). Etidronic acid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Nursing Mothers: It is not known whether Etidronic acid is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this drug is administered to a nursing woman.
 SIDE EFFECTS
- Gastrointestinal complaints (diarrhea, nausea)
- In Paget's patients, increased or recurrent bone pain at pagetic sites, and/or the onset of pain at previously asymptomatic sites has been reported.