Drug information of tiludronate

Half-Life: 50 (single dosing) -150 hr (repeated dosing)

Onset: 2 days -1 month

Peak Effect: 3 month

Duration: 3-6 months after completion (multiple doses)

Peak plasma time: 2 hr

Bioavailability: 6%; food reduces bioavailability by up to 90%

Protein bound: 90%

Metabolism: None

Excretion: Urine

Usual Adult Dose for Paget's Disease

-400 mg orally once a day for a period of 3 months

Renal Impairment

ClCr< 30 mL/min: Not recommended

Not removed by dialysis

-Failure to follow administration instructions for this drug may increase the risk of esophageal adverse reactions.
-Discontinue this drug and seek medical attention if dysphagia, odynophagia, retrosternal pain or new or worsening heartburn develop

- Not recommended in severe renal failure (CrCl <30 mL/min)

-Risk of osteonecrosis of jaw

-Risk of severe bone, joint &/or muscle pain

-This drug should be taken with 6 to 8 ounces of plain water only, for a period of 3 months.
-This drug should not be taken within 2 hours of food.
-Beverages other than plain water (including mineral water), food, and some medications are likely to reduce the absorption of this drug.
-Patients should not lie down for at least 30 minutes after taking this drug.
-Appropriate supervision is recommended in patients who cannot comply with dosing instructions due to mental or physical disability.
-Calcium, mineral supplements, aspirin, and indomethacin should be taken at least 2 hours before or two hours after this drug.
-Aluminum or magnesium containing antacids, if needed, should be taken at least two hours after taking this drug.
-Adequate vitamin D and calcium intake should be maintained.

-Monitoring Serum calcium and symptoms of hypocalcemia

- Following therapy, allow 3 months interval to assess response

-Avoid concurrent multivalent cation-containing medicines or food