This is an aminobisphosphonate which is a potent inhibitor of bone resorption.

Indications: reduction of bone damage in advanced malignancies involving bone; hypercalcaemia of malignancy.

Cautions: monitor serum electrolytes, calcium, phosphate and magnesium; assess renal function before each dose; ensure adequate hydration; renal impairment; cardiac disease (avoid fluid overload).

Side Effects: hypophosphotaemia, anaemia, influenza- like symptoms; gastrointestinal disturbances, headache, conjunctivitis; renal impairment. Osteonecrosis of the jaw reported in cancer patients being treated with bisphosphonate; consider dental examination and preventive treatment before initiating bisphosphonate; avoid invasive dental procedures during treatment.

Dose: IV infusion of 4mg every 3-4 weeks (reduction of bone damage in advanced malignancies) and 4mg as a single dose (hypercalcaemia of malignancy).