Hypercalcemia of Malignancy
Consideration should be given to the severity of as well as the symptoms of
hypercalcemia. Vigorous saline hydration alone may be sufficient for treating
mild, asymptomatic hypercalcemia. Overhydration should be avoided in patients
who have potential for cardiac failure. In hypercalcemia associated with
hematologic malignancies, the use of glucocorticoid therapy may be helpful.
The recommended dose of Aredia in moderate hypercalcemia (corrected serum
calcium* of approximately 12-13.5 mg/dL) is 60 to 90 mg given as a SINGLE-DOSE,
intravenous infusion over 2 to 24 hours. Longer infusions (i.e., >2 hours) may
reduce the risk for renal toxicity, particularly in patients with preexisting
The recommended dose of Aredia in severe hypercalcemia (corrected serum
calcium*>13.5 mg/dL) is 90 mg given as a SINGLE-DOSE, intravenous infusion over
2 to 24 hours. Longer infusions (i.e., >2 hours) may reduce the risk for renal
toxicity, particularly in patients with preexisting renal insufficiency.
Aredia is excreted intact primarily via the kidney, and the risk of
renal adverse reactions may be greater in patients with impaired renal
function. Patients who receive Aredia should have serum creatinine
assessed prior to each treatment. In patients receiving Aredia for bone
metastases, who show evidence of deterioration in renal function, Aredia
treatment should be withheld until renal function returns to baseline.
In clinical trials, patients with renal impairment (serum
creatinine >3.0 mg/dL) have not been studied. Limited
pharmacokinetic data exist in patients with
creatinine clearance <30 ml/min. For the treatment of bone
metastases, the use of Aredia in patients with severe renal impairment
is not recommended. In other indications, clinical judgment should
determine whether the potential benefit outweighs the potential risk in
Not Studied. Not recommended.
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The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
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