Many countries, since 1988, have been using Clodronate to help stop cancer from spreading to the bone which is usually associated with breast, prostate, colon and lung cancer.
It is also used on patients with multiple myeloma to prevent fractures and diminish the pain and lowers the calcium level.
The results of this treatment may avoid radiotherapy.
Since
the beginning of the 1980's the use of bisphosphonates in treating
tumor-induced hypercalcemia has had major relevance in the medical
society. There are many articles available now with proven testing that
biphosphonates used at the right dosage can prevent hypercalcemia, which
is due to cancer in bone, which may manifest itself in the form of pathologic
fractures and bone destruction. It will also help the severe pain
due to the metastasis caused by the spreading of the cancer to the
bone.
Osteolysis of malignant disease (metastasis) arises from increased bone resumption, usually associated with the increased osteoclast activity and deficient osteoblast response (the rebuilder of the bone), that results in a progressive loss of bone. As the problem progresses, the bones change the structure and become fragile and weak and may break easily.
Clodromax
clodronate disodium is a bone resumption inhibitor that is available
in:
-
Ampoules
-
Capsules
-
Intravenous
-
Oral administration
Each
ampoule contains 20ml of sterile solution with 100mg per ml. of clodronate
disodium. The pH of the solution of clodronate disodium is approximately
6.3. Clodromax is a member of the group of chemical compounds
known as bisphosphonates. Clodronate disodium is designated
chemically as "disodium dihydrogen" (1-hydroxyethytidene)
bisphosphonate.
Clinical Pharmacology
Because of decreased release of phosphate from bone and increased renal excretion as parathyroid hormone levels which are usually suppressed in hypercalcemia associated with malignancy action of Clodromax is inhibition of bone resumption, although the mechanism of antiresorptive action is not completely understood.
Several
factors contribute to this action. Clodromax absorbs calcium phosphate
(hydroxyapatite) crystal in bone, in vitro studies also suggest that
inhibition of osterclast activity contribute to the inhibition of
bone resumption in animal studies as doses recommended for the
treatment of hypercalcemia.
Clodromax
inhibits bone resumption apparently without inhibiting bone formation
and mineralization of relevance to the treatment of hypercalcemia. Serum phosphate levels have been noted to decrease after administrating
Clodromax. They return to normal within 7-10 days.
Indications and Usage
Clodromax
must be used in conjunction with adequate hydration, which is indicated
for treatment of moderate or severe hypercalcemia that is associated
with malignancy with or without bone metastasis.
Patients
who have epidermis tumors respond to this treatment, but vigorous
saline hydration is an integral part of hypercalcemia therapy and
must be initiated promptly to restore urine output to about 2 liters
daily throughout the treatment. Overhydration, especially in those
patients who have cardiac failure, must be avoided.
Contraindication
Clodromax
is contraindicated in patients with clinically significant hypersensitivity
to other bisphosphonates
Dosage:
-
High temperature
-
Redness
-
Swelling
-
Pain in the area of the application (infusion method).
-
Occasionally tiredness
-
Nausea
-
Epigastric pain
-
Lack of appetite
-
Alterations
in taste occur relatively often, but will eventually disappear.
-
The
oral form may, although very rare, cause a reaction in those
patients who have active gastro-duodenal ulcers.
Reference Publications Available:
Double
blind, placebo controlled, dose-response trial of oral Clodronate in
patients with bone metastasis. Noelle Or'Rourke, Eugene McCloskey, Journal
of Clinical Oncology, Vol 13, No. 4 (April 1995, pp 929-934)
Reduction
in calcium excretion in women with breast cancer and bone metastasis
using oral Clodronate (bisphosphonate pamidronate) D.J. Dodwell, A.
Howell, Br. J Cancer 1990, Jan.: 61(1): 123-5.
Clodronate and Osteoporosis. Kanis J.A., McCloskey EV Maturitas 1996, 23 (suppl): 581-6
Pharmacology and use in the treatment of tumor-induced hypercalcemia and metastasic bone disease. Fleish H. Drugs 1991; 42:919-44
Natural
history of skeletal disease in multiple myelomatosis and treatment with
Clodronate. McCloskey EV, O'Rouke N.bone Miner 1992: 17 (suppl): S27
Palliation
of painful bone metastasis from prostate cancer using sodium etidronate
result in randomized, prospective double blind placebo controlled study.
Smith, J.A.. J.Urol 1989, 141: 85-7.
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