Bisphosphonate
Clodronate disodium
Brand names: Bonefos, Loron
Adult dose
Dose: Hypercalcaemia of malignancy: 1.6g/day PO (max 3.2g) or 300mg/day IV infusion. Bone metastases: 1.6g/day PO
Route: PO/IV
Frequency: OD
Dose adjustments
Renal
Reduce dose by 50% if CrCl 10–30; avoid if CrCl <10
Clinical pearls
- Take on empty stomach with water; do not lie down for 30 min
- Dental review prior to long-term use
Contraindications
- Severe renal impairment
- Pregnancy/breastfeeding
Side effects
- GI upset
- Hypocalcaemia
- Renal impairment
- Osteonecrosis of jaw (rare)
Interactions
- Calcium/iron/antacids reduce absorption
- NSAIDs increase renal toxicity
Monitoring
- Calcium
- U&E
Reference: BNF; https://bnf.nice.org.uk/drugs/clodronate-disodium/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158