Reduced dose may be advisable in presence of renal impairment. In patients with Class Cc renal function, reduce dose and only if expected benefit justifies potential risks. Concurrent therapy with etidronate IV infusion is recommended as soon as urine output is restored. Monitor renal function in patients given parenteral form every few days for first 2 wk of therapy. Monitor patients with predominantly lytic lesions radiographically and biochemically to permit termination of therapy in unresponsive patients.
Oral form is contraindicated in patients with known hypersensitivity to etidronate.
Oral form is contraindicated in patients with clinically overt osteomalacia. Therapy with oral form has been withheld from some patients with enterocolitis since diarrhea may be experienced, particularly at higher doses. Rare cases of acute renal failure seen. In some patients with preexisting renal impairment or in those given potentially nephrotoxic drugs, further depression of renal function sometimes seen. Ensure that renal function is adequate to handle increased fluid load and excretion of drug.