Ibandronic acid

When ATH:
M05BA06

Characteristic.

Bisphosphonates III generation. Ibandronate sodium is white or almost white powder, easily soluble in water, practically insoluble in organic solvents.

Pharmacological action.
Inhibiting bone resorption.

Application.

Hypercalcemia of tumor diseases.

Contraindications.

Hypersensitivity, severe renal insufficiency (serum creatinine more 5 mg% or 442 mmol / l), pregnancy, lactation, childhood (no experience of).

Side effects.

Fervescence, flu-like symptoms (fever, chills, myalgia, ossalgia), hypocalcemia, reduction in the concentration of calcium in the urine, gipofosfatemiя, dyspepsia, bronchospasm (in patients with "aspirin" asthma), allergic reactions, Local reactions (pain and burning at the site / in the, phlebitis).

Cooperation.

Aminoglycosides increases the risk of developing hypocalcemia. Chemically compatible with calcium-containing solutions.

Overdose.

Symptoms: symptomatic hypocalcemia (convulsions, Symptoms Trousseau, Hvosteka, Weiss, Schlesinger, long QT interval ST isoelectric), renal failure and liver.

Treatment: administration of calcium gluconate (I /), hemodialysis (a critical change in plasma levels of creatinine and electrolytes).

Dosing and Administration.

It is used only in a hospital in the form of in / infusion. Before use, dilute the contents of sealed 500 ml of isotonic sodium chloride solution or 5% glucose solution; introducing drip within 2 no. The dosage is determined individually, depending on the severity and type of tumor hypercalcaemia. In patients with severe kaltsiemiey (serum calcium corrected for serum albumin ≥3 mmol / l) -one 4 mg. In moderate kaltsiemii (<3 mmol / l) - 2 mg dose. The maximum dose - 6 mg. Possible repeated infusion through 18-19 days (after administration of doses of 2-4 mg) or via 26 days (after a dose of 6 mg). Patients with osteolytic metastases recommended a lower dose, tumor than with humoral hypercalcemia.

The concentration of the albumin-corrected serum calcium (mmol / l) It is calculated as follows:: serum calcium (mmol / l) – (0,02 x albumin (g / l)) + 0,8.

Precautions.

During treatment it is necessary to monitor renal function, regular monitoring of calcium levels, phosphorus and magnesium levels (should be aware of the possibility of hypomagnesemia).

Recommendations for dosage adjustment in patients with severe liver disease (hepatic insufficiency) no, as clinical studies in this group of patients have not been conducted.

Prior to treatment, the patient should receive adequate hydration using 0,9% sodium chloride solution. It is recommended to avoid over-hydration in patients with circulatory failure.

It is necessary to carefully monitor, that the drug was administered only in / in and avoid it in the / and administration or contact with surrounding tissue.

Cooperation