Etidronate (patient information)

# Why this medication is prescribed
Etidronate is used to treat Paget's disease of bone (a condition in which the bones are soft and weak and may be deformed, painful, or easily broken) and to prevent and treat heterotopic ossification (growth of bone tissue in an area of the body other than the skeleton) in people who have had total hip replacement surgery (surgery to replace the hip joint with an artificial joint) or in people who have had an injury to the spinal cord. Etidronate is in a class of medications called bisphosphonates. It works by slowing the breakdown of old bone and the formation of new bone.

# How this medication should be used
Etidronate comes as a tablet to take by mouth. It is usually taken once or twice a day on an empty stomach. To help you remember to take etidronate, take it at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take etidronate exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.
You may swallow etidronate tablets with water or plain fruit juice. Do not swallow the tablets with milk, calcium fortified juice, or other drinks that contain calcium.
Do not eat for 2 hours before and 2 hours after you take etidronate. It is especially important not to eat or drink foods or drinks that are high in calcium such as milk for 2 hours before and after you take etidronate.
If you are taking etidronate to treat Paget's disease of bone, it may take some time for your condition to improve. You may experience new or worsening bone pain, especially at the beginning of your treatment. Tell your doctor about any new or worsening symptoms you experience, but do not stop taking etidronate without talking to your doctor.

# Other uses for this medicine
Etidronate is also used sometimes to treat and prevent osteoporosis caused by corticosteroids (a type of medication that may cause osteoporosis) treatment. Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before taking etidronate:
- tell your doctor and pharmacist if you are allergic to etidronate or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention anticoagulants ('blood thinners') such as warfarin (Coumadin); cancer chemotherapy; and oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are taking vitamin and mineral supplements such as iron, or if you are taking antacids containing calcium, magnesium, or aluminum (Maalox, Mylanta, Tums, others), take them 2 hours before or 2 hours after you take etidronate.
- tell your doctor if you have or have ever had osteomalacia (softening of bones due to a lack of minerals). Your doctor may tell you not to take etidronate.
- tell your doctor if you have or have ever had anemia (condition in which the red blood cells so not bring enough oxygen to all the parts of the body); difficulty swallowing, heartburn, ulcers, or other stomach problems; cancer; enterocolitis (swelling in the intestines), any type of infection, especially in your mouth; ,problems with your mouth, teeth, or gums; any condition that stops your blood from clotting normally; dental or kidney disease. Tell the doctor who prescribed etidronate if you break a bone at any time during your treatment.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Also *tell your doctor if you plan to become pregnant at any time in the future because etidronate may remain in your body for years after you stop taking it. Call your doctor if you become pregnant during or after your treatment with etidronate.
- you should know that etidronate may cause serious problems with your jaw, especially if you have dental surgery or treatment while you are taking the medication.A dentist should examine your teeth and perform any needed treatments before you start to take etidronate. Be sure to brush your teeth and clean your mouth properly while you are taking etidronate. Talk to your doctor before having any dental treatments while you are taking this medication.

# Special dietary instructions
It is important you get enough calcium and vitamin D and eat a balanced diet while you are taking etidronate. Your doctor will tell you which foods are good sources of these nutrients and how many servings you need each day. If you find it difficult to eat enough of these foods, tell your doctor. In that case, your doctor may prescribe or recommend a supplement.

# What to do if you forget a dose
If you have not already eaten, take the missed dose as soon as you remember it. If you have already eaten, take the missed dose 2 hours after you last ate. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Minor side effects
Etidronate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nausea
- diarrhea
- bone, joint, and/or muscle pain

## Severe side effects
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- difficulty swallowing or breathing
- blisters on the skin
- fever
Etidronate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- vomiting
- stomach cramps
- diarrhea
- pain, burning, numbness, or tingling in the hands or feet
- muscle spasms and cramps

# Other information
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to etidronate.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Didronel

# Other names
- EHDP