Clodronate (Bonefos)

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General information

Class/mechanism: Bisphosphonate, inhibits osteoclast activity, dissolution of hydroxyapatite crystals, and bone resorption/turnover.[1][2]
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Disease-specific information

For now this will be a gathering point for RCTs examining the use of this agent, which does not have clear antineoplastic properties; in the future this information may be moved to separate page(s).

Breast cancer

  • Diel IJ, Solomayer EF, Costa SD, Gollan C, Goerner R, Wallwiener D, Kaufmann M, Bastert G. Reduction in new metastases in breast cancer with adjuvant clodronate treatment. N Engl J Med. 1998 Aug 6;339(6):357-63. link to original article PubMed

Multiple myeloma

  • Lahtinen R, Laakso M, Palva I, Virkkunen P, Elomaa I. Randomised, placebo-controlled multicentre trial of clodronate in multiple myeloma. Finnish Leukaemia Group. Lancet. 1992 Oct 31;340(8827):1049-52. Erratum in: Lancet 1992 Dec 5;340(8832):1420. link to original article PubMed
  • MRC Myeloma IX: Morgan GJ, Davies FE, Gregory WM, Cocks K, Bell SE, Szubert AJ, Navarro-Coy N, Drayson MT, Owen RG, Feyler S, Ashcroft AJ, Ross F, Byrne J, Roddie H, Rudin C, Cook G, Jackson GH, Child JA; National Cancer Research Institute Haematological Oncology Clinical Study Group. First-line treatment with zoledronic acid as compared with clodronic acid in multiple myeloma (MRC Myeloma IX): a randomised controlled trial. Lancet. 2010 Dec 11;376(9757):1989-99. Epub 2010 Dec 3. link to original article link to PMC article PubMed

Patient drug information

History of changes in FDA indication

Not FDA approved; used in several other countries (Canada, Australia, the United Kingdom, Italy, others).

Also known as

  • Generic names: clodronate disodium, clodronic acid disodium tetrahydrate
  • Brand names: Clasteon, Clastoban, Climaclod, Clodeosten, Clodran, Clodron, Clody, Difosfonal, Disdual, Lodronat, Loron, Lytos, Mebonat, Moticlod, Niklod, Ossiten, Ostac, Osteonorm, Osteostab, Sindronat

References

  1. 1.0 1.1 Clodronate (Bonefos) package insert
  2. Clodronate (Bonefos) package insert (locally hosted backup)
  3. Clodronate (Bonefos) patient drug information (UpToDate)