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Didronel PMO

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VOL: 101, ISSUE: 27, PAGE NO: 31

Generic and proprietary names

Generic and proprietary names
- Didronel PMO.

Action
- Didronel PMO contains disodium etidronate and calcium carbonate.

- Disodium etidronate decreases the rate of bone turnover and calcium carbonate increases calcium content.

Classification
- Bisphosphonate and other drugs affecting bone metabolism.

Indications
- Treatment of osteoporosis.

- Prevention of bone loss in postmenopausal women.

- Prevention and treatment of corticosteroid-induced osteoporosis.

Contraindications
- Breastfeeding.

- Pregnancy.

- Hypercalcaemia.

- Hypercalciuria.

- Moderate to severe renal impairment.

- Osteomalacia.

Cautions
- Renal impairment.

Common side-effects
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.

Rare side-effects
- Exacerbation of asthma.

- Angioedema.

- Rash or itching.

- Headache.

- Paraesthesia.

- Blood disorders.

Interactions
- Absorption reduced with calcium salts or calcium-containing products such as milk or other dairy produce.

- May reduce absorption of tetracycline-type antibiotics.

- Vitamin D increases the absorption of calcium.

- If the amount of calcium in the blood becomes too high, it may enhance the effect of digoxin or other cardiac glycosides.

Administration
- The two elements of Didronel PMO are taken as a 90-day cyclical regimen. The disodium etidronate tablets are taken for the first 14 days of the treatment cycle, followed by the calcium carbonate tablets for 76 days.

- Calcium tablets are effervescent.

Patient teaching
- This medicine contains the colouring sunset yellow (E110), which can cause an allergic-type reaction.

- The disodium etidronate tablets should be taken with water on an empty stomach.

- The calcium carbonate tablets should be dissolved in water before taking.

- Patients should report any sudden onset of unexplained pain or restricted mobility.

Nursing considerations
- Continuous high-dose use of disodium etidronate is not recommended as it can impair bone mineralisation leading to increased risk of fractures.

- Calcium levels in blood and urine should be monitored in people with kidney disease.

- The therapeutic response should be evaluated.

Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines.

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