Mechanism of Action
Bisphosphonate; inhibits bone resorption via actions on osteoclast activity, leading to indirect increase in bone density

Onset: Hypercalcemia of malignancy, 4-7 days; osteolytic bone metastases, 1 week
Duration: 32 days
Protein bound: 28-53%
Not metabolized
Half-life: 146 hr (terminal)
Renal clearance: 66 mL/min
Total body clearance: 5.6 L/hr
Excretion: Urine (39% as unchanged drug) within 24 hr, feces (<3%)
IV Incompatibilities
Calcium-containing solutions
IV Preparation
Reconstitute powder with 5 mL SWI; once powder is fully dissolved, dilute further in 100 mL NS or D5W before administering
Infusion of solution must be completed within 24 hours of initial reconstitution
IV Administration
Infuse over ≥15 minutes, in line separate from other medications
Ensure appropriate hydration, especially in patients on diuretics
Before dilution, store vials at 25°C (77°F); after final dilution, use solution immediately or store at 2-8°C (36-46°F)
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