Tiludronate

C 9H33C10(iP2S 89987-31-5) see Tiludronate disodium tetraisopropyi methylenediphosphonate... 

Tablets 240 mg (equiv. to 200 mg tiludronic acid) Rx) Skelid (Sanofi-Synthelabo)... 

Paget disease of bone For treatment of Paget disease of bone where alkaline phosphatase is at least 2 times the upper limit of normal, or those who are symptomatic or at risk for future complications from their disease (alendronate, risedronate, tiludronate) treatment of symptomatic Paget disease (etidronate) treatment of moderate to severe Paget disease (pamidronate). 

TILUDRONATE Administer a single 400 mg/day oral dose, taken with 6 to 8 ounces of plain water only for a period of 3 months. Beverages other than plain water... 

Tiludronate - Bioavailability is reduced by food. Tiludronic acid is... 

Tiludronate - Tiludronate is not recommended for patients with severe renal failure (Ccr less than 30 mL/min). 

Pregnancy Category D (zoledronic acid) Category C (alendronate, oral and IV etidronate, pamidronate, risedronate, and tiludronate). 

Drugs that may interact with alendronate include ranitidine and aspirin. Drugs that may interact with tiludronate include aspirin and indomethacin. Calcium... 

Bioavailability of tiludronate was reduced when administered with, or 2 hours after, breakfast compared with administration after an overnight fast and 4 hours before a standard breakfast. 

Agents include etidronic acid, pamidronic acid, clodronic acid, alendronic acid, ibandronic acid, rise-dronic acid, zoledronic acid and tiludronic acid. Formulations of clodronic acid and pamidronic acid are available for intravenous administration. The indications for the use of bisphosphonates include treatment of postmenopausal osteoporosis, hypercal-caemia of malignancy and Paget s disease. 

C) Use tiludronate in 18-month cycles to prevent progression of the disease to other parts of the body. 

I Contraindications Hypersensitivity to other bisphosphonates, including etidronate, tiludronate, risedronate, and alendronate hypocalcemia inability to stand or sit upright for at least 20 min renal impairment when serum creatinine clearance is greater than 5 mg/dl... 

Paget s disease PO 400 mg once a day for 3 mo. Must takewith6-8oz plain water. Do not give within 2 hr of food intake. Avoid giving aspirin, calcium supplements, mineral supplements, or antacids within 2 hr of tiludronate administration. 

Adjusted serum calcium, serum alkaline phosphatase, osteocalcin, and urinary hy-droxyproline levels to assess the effectiveness of tiludronate... 

The bisphosphonates are analogs of pyrophosphate in which the P-O-P bond has been replaced with a nonhydrolyzable P-C-P bond (Figure 42-4). Etidronate, pamidronate, and alendronate have now been joined by risedronate, tiludronate, ibandronate, and zoledronate for clinical use. The bisphosphonates owe at least part of their clinical usefulness and toxicity to their ability to retard formation and dissolution of hydroxyapatite crystals within and outside the skeletal system. They localize to regions of bone resorption and so exert their greatest effects on osteoclasts. However, the exact mechanism by which they selectively inhibit bone resorption is not clear. 

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