Drug reference

Sodium clodronate

Bisphosphonate · Agent for bone disorders

Also known as Loron, Bonefos, Clasteon

BisphosphonateAgent for bone disorders

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Avoid.

FDA category + note

Mechanism

Sodium clodronate is a first-generation non-nitrogen-containing bisphosphonate that is metabolized intracellularly by osteoclasts to a non-hydrolyzable ATP analogue (AppCCl2p), which accumulates and inhibits ATP-dependent intracellular enzymes, leading to osteoclast apoptosis. This mechanism is fundamentally different from nitrogen-containing bisphosphonates (alendronate, zoledronic acid) which target farnesyl pyrophosphate synthase. Clodronate is less potent than nitrogen-containing bisphosphonates and is primarily used for tumor-associated hypercalcemia and bone metastases.

Indications

Osteolytic lesionsHypercalcaemiaBone pain associated with skeletal metastases in patients with breast cancer or multiple myeloma

Dosing

Adult: Initial dose: 1-2 tablets of 520 mg daily in 1-2 divided doses, increased if necessary up to 4 tablets (2080 mg) daily.
Renal adjustment: Avoid if eGFR less than 10 mL/minute/1.73 m2. Max. initial dose 1200 mg daily if eGFR 30-50 mL/minute/1.73m2. Use half normal dose if eGFR 10–30 mL/minute/1.73 m2. Monitor renal function before and during treatment. Monitor serum calcium and serum phosphate before and during treatment. Avoid food for 2 hours before and 1 hour after treatment, particularly calcium-containing products e.g.…
Max dose: 2080 mg daily