Hormones and Agents Affecting Hormonal Mechanism: Calcium Regulating Agents
IACLA1 “Aclasta powder for sol’n for infusion” 0.05 mg/mL; 100 mL/bot
IZOME1 “Zometa powder for sol’n for infusion” 4 mg/ vial
適應症：
IACLA1：治療骨佩吉特氏病 (Paget’s disease of bone) 治療停經後婦女的骨質疏鬆症，以降低發生髖關節、脊椎與非脊椎性骨折的機率，並增加骨密度。
IZOME1：與標準癌症治療併用，適用於多發性骨髓瘤及固體腫瘤併有骨骼轉移之病人。用於攝護腺癌病人之骨骼轉移時，應至少接受過一種荷爾蒙治療而仍持續惡化者。治療惡性腫瘤之高血鈣併發症(HCM)。
Usual dose:
Bone metastasis (Solid tumor, Multiple myeloma): 4 mg IV infused over no less than 15 min q3-4wks.
Hypercalcemia of malignancy: 4 mg IV given as a single dose infusion over no less than 15 min.
Dose adjustment:
Renal failure: CrCl 50-60 ml/min, 5-mg IV; CrCl 40-49 ml/min 3.3-mg IV; CrCl 30-39 ml/min 3-mg IV.
Precaution: aspirin-sensitive asthma, history; bisphosphonates have been associated with bronchoconstriction.
Adverse effect:
Common: peripheral edema, weight decreased, abdominal pain, constipation, diarrhea, loss of appetite, nausea, vomiting, arthralgia, backache, asthenia, dizziness, headache, insomnia, paresthesia, nephrotoxicity, fatigue, fever.
Serious: atrial fibrillation, cerebrovascular accident, aseptic necrosis of bone (jaw), bone pain, myalgia, dyspnea, death.
健保使用規範：限符合下列條件之一患者使用：(98/6/1、100/1/1)
1.用於治療惡性腫瘤之高血鈣併發症 (HCM)，且限用於血清鈣濃度超過2.75 mmol/L (11.0mg/dL) 或游離鈣大於5.6 mg/dL (93/6/1)。
2.Multiple Myeloma，Breast Cancer，Prostate Cancer併有蝕骨性骨轉移之病患 (96/1/1)。
3.Aclasta ( 98/6/1、100/1/1)用於變形性骨炎(Paget’s disease)