How does this medication work? What will it do for me?
Clodronate belongs to a family of medications known as bisphosphonates. It is used to treat hypercalcemia (high blood calcium) for people who have cancer. Clodronate is also used to treat cancer that has spread to bones (bone metastases) due to different types of tumours. Clodronate works by reducing the breakdown of bone.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each blue-and-white, gelatin capsule contains 400 mg of clodronate. Nonmedicinal ingredients: gelatin, iron oxide, magnesium stearate, maize starch, polydimethyl siloxane, shellac, sodium starch glycolate, soya lecithin, talc, and titanium oxide.
How should I use this medication?
To treat hypercalcemia (high blood calcium) for people who have cancer, clodronate is started with an intravenous infusion (injection into the vein), and then switched to oral (by mouth) maintenance treatment.
The recommended adult dose of the intravenous infusion is 300 mg daily. Following intravenous treatment, oral treatment is started at a recommended dose of 1,600 mg to 2,400 mg daily given as a single daily dose or as 2 divided doses. The maximum recommended daily dose is 3,200 mg.
To treat cancer that has spread to bones (bone metastases) due to different types of tumours, the recommended initial dose is 1,600 mg daily given orally (by mouth). If needed, this dose may be increased by your doctor. The maximum daily dose is 3,200 mg.
Clodronate capsules should be taken on an empty stomach with a glass of plain water, at least 2 hours before or after food.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you:
- are allergic to clodronate or any ingredients of this medication
- are allergic to other bisphosphonates (e.g., alendronate, etidronate, risedronate)
- are pregnant or breast-feeding
- are taking other bisphosphonate medications (e.g., alendronate, etidronate, risedronate)
- have reduced kidney function
- have severe inflammation of the gastrointestinal tract
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- loss of appetite
- stomach pain
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- difficulty breathing, wheezing
- mouth pain
- muscle cramps in the hands, arms, feet, legs, or face
- skin rash and hives
- unusual tiredness or weakness
Stop taking this medication and seek immediate medical attention if any of the following occur:
- pain, swelling, infection, or poor healing of the gums, loose teeth, or numbness of the jaw
- symptoms of a severe allergic reaction, e.g.:
- difficulty breathing
- swelling of the throat or mouth
- symptoms of severe bone, joint, and/or muscle pain
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Deterioration of the jaw bone: People with cancer treated with clodronate (or other bisphosphonates) may, though rarely, develop osteonecrosis of the jaw (deterioration of the jaw bone). If you experience any pain, swelling, or infection of the jaw report this to your doctor. Before starting treatment with clodronate, your doctor may recommend that you see a dentist for an examination and any necessary dental treatment. While receiving clodronate, try to avoid invasive dental procedures such as tooth extractions.
Kidney problems: If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor will monitor your kidney function during and after intravenous infusions of clodronate.
Low calcium levels: Clodronate may cause low calcium levels. You will need to have regular blood tests while taking clodronate to monitor your calcium levels.
Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if clodronate passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication has not been established for children.
What other drugs could interact with this medication?
There may be an interaction between clodronate and any of the following:
- aminoglycosides (e.g., gentamicin, tobramycin)
- antacids or any medications or supplements containing calcium, iron, magnesium, or aluminum
- calcium-containing intravenous solutions (e.g., Ringer's solution)
- corticosteroids (e.g., prednisone)
- dietary supplements containing calcium, iron, magnesium, or aluminum
- estramustine phosphate
- loop diuretics (e.g., furosemide)
- nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., diclofenac, ibuprofen, naproxen, ketoprofen)
- phosphate supplements
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.