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This information is about a drug called clodronate that can be used when cancer has spread to the bone.
If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer information nurse specialists.
Clodronate belongs to a group of drugs called bisphosphonates. Bisphosphonates are commonly used to treat osteoporosis (bone thinning). In certain situations bisphosphonates can help protect your bones against some of the effects of secondary bone cancer, such as pain and weakness. Secondary bone cancer occurs when the original cancer (the primary) spreads to form a secondary cancer (metastasis) in the bone.
Clodronate is often given alongside other cancer treatments. As well as being used in some types of secondary bone cancer it has been shown to be effective in people with myeloma (a cancer of the plasma cell). It is also used to reduce a raised calcium level in the blood.
In secondary bone cancer, calcium (which helps to strengthen the bones) can be lost from the damaged bone and can seep into the bloodstream. When the level of calcium in the blood is raised this is known as hypercalcaemia and can cause symptoms such as feeling or being sick (nausea or vomiting), tiredness, irritability and sometimes confusion. Clodronate can help to reduce high levels of calcium.
Secondary cancer in the bones may cause them to become weakened, and in some situations they may break or fracture. Clodronate can help to re-strengthen the bone and reduce the risk of fractures.
Cancer can affect the bones in different ways and clodronate is not helpful for all cancers that affect the bones. Your doctor or specialist nurse can tell you if clodronate would be helpful for you.
In normal bone, two types of cell (osteoclasts and osteoblasts) work together constantly to shape, rebuild and strengthen existing bone:
Myeloma and some secondary bone cancers can produce chemicals that make the osteoclasts work harder. This means that more bone is destroyed than rebuilt, and leads to weakening of the affected bone. This can cause pain and means that the bone can fracture or break more easily.
Clodronate targets areas of bone where the osteoclast activity is high. It helps to bring the balance of osteoclast and osteoblast activity back to normal. This can reduce pain and help to strengthen the bone. It also means that less calcium will be lost from the bones.
Clodronate is a tablet or capsule usually taken either once or twice a day. It is recommended that you take the tablets in the morning and evening and not within 1–2 hours of eating, having a milky drink, or taking other medicines. Your nurse, doctor or pharmacist will explain how you should take your tablets.
If you are having clodronate to lower your calcium level, you may be given tablets or capsules to maintain your calcium at a normal level. If your calcium level is very high, you may also be given a single dose of a bisphosphonate drug into the vein (intravenously) to bring it down faster.
If you are having clodronate to reduce pain, or strengthen your bones, then you may need to take it for as long as it seems to be working for you.
Each person’s reaction to any medication is different. Most people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who has clodronate and may be different if you are having more than one drug.
We have outlined the most common side effects. However, we have not included those that are rare and therefore extremely unlikely to affect you. If you notice any effects that are not listed in this information, please discuss them with your doctor or nurse.
Abdominal (tummy) pain and diarrhoea Sometimes, clodronate can cause diarrhoea. This can usually be controlled easily with medicine, but let your doctor know if it is severe or if it continues.
Feeling sick (nausea) or being sick (vomiting) Nausea & vomiting is uncommon and usually mild. It can be well controlled with anti-sickness (anti-emetic) medication.
Drop in calcium levels below normal This is rare and usually only temporary. Your doctor will carry out regular blood tests to monitor the level of calcium in your blood.
Change in kidney function Clodronate can sometimes affect how your kidneys work. This does not usually cause any symptoms and the effects are generally mild. Your doctor will monitor how well your kidneys are working during your treatment by doing regular blood tests.
Jaw problems (osteonecrosis) This is a very rare side effect of ibandronic acid. It is more common in people who have had teeth removed or other dental procedures while taking ibandronic acid. Osteonecrosis is when healthy bone dies off in a way that is not normal. It can result in poor healing of the gums or loosening of teeth. If possible, dental treatment should be avoided while taking ibandronic acid. It’s important to let your dentist know that you are taking Ibandronic acid. Also, let your doctor know if you need dental treatment while taking ibandronic acid.
This section has been compiled using information from a number of reliable sources, including:
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