Health Centres - Didronel
How does it work?
Didronel tablets contain the active ingredient etidronate disodium, which is a type of medicine known as a bisphosphonate. (NB. Etidronate disodium is also available without a brand name, ie as the generic medicine.) Bisphosphonates are medicines that reduce the turnover of bone.
Bone is not a static structure. It is continually shaped, reformed and rebuilt by cells called osteoblasts and osteoclasts. These cells continously deposit and remove calcium and phophorous, stored in a protein network that makes up the structure of the bone. Old bone is broken down by the osteoclasts and new bone is formed by the osteoblasts.
In Paget's disease of bone the normal metabolism of bone is disturbed. There is an increase in bone breakdown by the osteoclasts and increased and irregular formation of new bone by the osteoblasts. The normal bone marrow also becomes replaced with blood vessels and fibrous tissue. In this disease there are often no symptoms for many years, but over time the bones can become enlarged, deformed, painful, weak and prone to breaking. The enlarged and deformed bones can also put pressure on nerves, causing pain and muscle weakness.
Etidronate disodium works by binding very tightly to the bone and preventing the calcium being removed by the osteoclasts. This stops the osteoclasts from breaking down the bone. It also reduces the rate of bone formation by the osteoblasts. The reduced bone turnover helps to reduce deformity and keep the bones strong and less likely to break.
What is it used for?
- Bone disease called Paget's disease, in which there is excessive breakdown of bone and increased and irregular formation of bone, causing the bones to become enlarged, deformed, painful, weak and prone to breaking.
Warning!
- Your doctor may want to monitor various components of your blood and urine while you are taking this medicine, to make sure it is working properly.
- If you have kidney problems or have ever had a kidney stone, the amount of calcium in your blood and urine should be regularly monitored while you are taking this medicine.
- People with Paget's disease are more likely to break bones. If you fracture a bone while taking this medicine, treatment should be stopped and not restarted until the bone is completely healed. This is because the medicine can slow down the mineralisation of newly formed bone tissue, so may make the healed bone tissue weak.
- Your course of treatment will be a maximum of either three or six months, depending on the dose your doctor has prescribed you. If your doctor decides re-treatment is necessary after this time because the disease has flared up again, etidronate should only be re-started after you have had an interval of at least three months without taking it.
- The class of medicines that etidronate disodium belongs to (bisphosphonates) has been associated with a rare condition called osteonecrosis of the jaw. The majority of cases of this condition have been in cancer patients treated with bisphosphonates by injection into a vein and many of these patients were also having treatment with chemotherapy or corticosteroids. However, the condition has also been seen in people taking bisphosphonates by mouth. The risk may be increased by poor oral hygiene, dental problems, teeth extractions and oral surgery. For this reason, your doctor may want you to have a dental examination and, if necessary, appropriate preventive dentistry, before you start treatment with this medicine. Discuss this with your doctor. It is important to look after your mouth and teeth as much as possible while you are receiving this medicine. Invasive dental procedures such as tooth extraction or surgery should be avoided if possible. If you need to see a dentist during treatment, make sure they know you are receiving this medicine.
Use with caution in
- Mildly decreased kidney function
- History of kidney stones
- Chronic (long-term) diarrhoea.
Not to be used in
- Children
- Moderate to severely decreased kidney function
-
Softening of the bones due to a lack of vitamin D and calcium
-
Pregnancy
- Breastfeeding.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and Breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine in pregnancy has not been established. It should not be taken by women who are pregnant, and women who could get pregnant should use an effective method of contraception to prevent pregnancy while taking this medicine. Seek further medical advice from your doctor.
- It is not known if this medicine passes into breast milk. It should not be used by women who are breastfeeding. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Diarrhoea
- Nausea
- Pins and needles (paraesthesia)
- Confusion
- Increased bone pain
- Pain in the joints (arthralgia)
- Severe swelling of lips, face or tongue (angioedema)
- Rash or itching
- Worsening of asthma
- Worsening of peptic ulcer
- Blood disorders
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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