Health Centres - Didronel PMO
How does it work?
Didronel PMO contains two different types of tablet, Didronel and Cacit. The Didronel tablets contain the active ingredient etidronate disodium, which is a type of medicine known as a bisphosphonate. Bisphosphonates are medicines that prevent the breakdown of bone. The Cacit tablets contain calcium carbonate and are used as a calcium supplement.
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 women at the menopause, blood levels of the female hormone oestrogen start to decrease. This results in an increase in bone breakdown by the osteoclasts, which can lead to a loss of bone density. Bone loss is particularly rapid for the first ten years after the menopause and it may lead to the development of osteoporosis - a condition in which the bones become weak and brittle and break (fracture) more easily.
Osteoporosis can also occur in men and as a result of long-term treatment with corticosteroid medicines such as prednisolone.
Etidronate is used both to prevent bone loss in people who are at risk of developing osteoporosis, and to prevent fractures in people who already have osteoporosis. The medicine 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, which helps to keep the bones strong and less likely to break.
Etidronate is used to treat osteoporosis, and also to prevent bone loss in postmenopausal women at risk of developing osteoporosis. Risk factors for osteoporosis include a history of smoking, a family history of osteoporosis, early menopause, thin body build and long-term treatment with corticosteroids, eg prednisolone.
Calcium is as essential mineral needed for many purposes in the body, including the formation of strong bones. Calcium requirements are raised in the years following the menopause, and when dietary intake of calcium is low. Calcium supplements have been shown to help prevent bone loss.
The Didronel and Cacit tablets are taken as a 90 day cyclical regimen to slow the breakdown of bone. One Didronel tablet is taken each day for the first 14 days of the treatment cycle, followed by one Cacit tablet each day for the remaining 76 days.
What is it used for?
- Prevention of bone loss in women who have passed the menopause and are at risk of osteoporosis
- Prevention and treatment of osteoporosis caused by long-term treatment with corticosteroids such as prednisolone.
Warning!
- Didronel tablets should be taken with water on an empty stomach, at the mid-point of a four hour fast, ie at least two hours after food and at least two hours before food. This is because food and some drinks (particularly milk) can interfere with the absorption of the medicine from the gut and hence make it less effective.
- Cacit tablets should be dissolved in water before taking.
- 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.
- This medicine contains the colouring sunset yellow (E110), which can cause an allergic-type reaction. This allergy is more common in people who are allergic to aspirin.
- 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
- Decreased kidney function
- History of kidney stones
- Chronic (long-term) diarrhoea.
Not to be used in
- Children
- Severely decreased kidney function
-
Softening of the bones due to a lack of vitamin D and calcium
- High levels of calcium in the blood (hypercalcaemia)
- High levels of calcium in the urine (hypercalciuria)
- Inflammation of the mucous membrane of both small and large intestines (enterocolitis)
-
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.
Label warnings
- Follow the printed instructions you have been given with this medication.
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