Tiludronate disodium
Tiludronate disodium (Skelid)
Tiludronate disodium
(tye- LOO-droh-nayt)
Pregnancy Category: C Skelid (Rx)

Classification: Bone growth regulator

Action/Kinetics: Inhibits activity of osteoclasts and decreases bone turnover. Does not interfere with bone mineralization. Poorly absorbed from GI tract when fasting and in presence of food. Peak serum levels: 2 hr. Not metabolized; excreted in urine. t 1/2: About 150 hr.

Uses: Treatment of Paget's disease where level of serum alkaline phosphatase is at least twice upper limit of normal, in those who are symptomatic, or who are at risk for future complications of disease.

Contraindications: Not recommended for those with C _CR less than 30 mL/min.

Special Concerns: Use with caution during lactation and in those with dysphagia, symptomatic esophageal disease, gastritis, duodenitis, or ulcers. Safety and efficacy have not been determined in children.

Side Effects: GI: Diarrhea, N&V;, dyspepsia, flatulence, tooth disorder, abdominal pain, constipation, dry mouth, gastritis. Body as whole: Pain, back pain, accidental injury, flu-like symptoms, chest pain, asthenia, syncope, fatigue, flushing. CNS: Headache, dizziness, paresthesia, vertigo, anorexia, somnolence, anxiety, nervousness, insomnia. CV: Dependent edema, peripheral edema, hypertension, syncope. Musculoskeletal: Arthralgia, arthrosis, pathological fracture, involuntary muscle contractions. Respiratory: Rhinitis, sinusitis, URTI, coughing, pharyngitis, bronchitis. Dermatologic: Rash, skin disorder, pruritus, increased sweating, Stevens-Johnson type syndrome (rare). Ophthalmic: Cataract, conjunctivitis, glaucoma. Miscellaneous: Hyperparathyroidism, vitamin D deficiency, UTI, infection.

Overdose Management: Symptoms: Hypocalcemia. Treatment: Supportive.

Drug Interactions: Antacids, aluminum- or magnesium-containing / Antacids, taken 1 hr before, tiludronate bioavailability Aspirin / Aspirin, taken 2 hr after, tiludronate bioavailability by 50% Calcium / Tiludronate bioavailability when taken at same time Indomethacin / Tiludronate bioavailability by 2- to 4-fold

How Supplied: Tablets: 200 mg

Dosage
?Tablets Paget's disease.
Adults: Single 400 mg dose/day taken with 6 to 8 oz of plain water for period of only 3 months.