Bonefos (generic name: sodium clodronate) is used to treat high levels of calcium in the blood that are caused by cancer; fragile bone caused by the spread of cancer from breast to bone; and bone fragility and destruction caused by multiple myeloma.

Bonefos is a bisphosphonate, and a potent inhibitor of osteoclast- mediated bone resorption. Consequently, Bonefos is able to inhibit cancer cell stimulated osteolytic activity, thereby helping the structure of the bone. Bonefos is approved in as many as 79 countries for the treatment of tumor- induced osteolysis and hypercalcemia. So far, there is approximately 260,000 patient years of experience with Bonefos as a marketed product.

Adverse Effects of Bonefos

Diarrhea may occur in approximately 10% of patients, but this reaction is generally mild, and did not lead to early drug discontinuation as compared to placebo control in a large, randomized, double blind clinical trial.

Dosage of Bonefos

Bonefos is available in 400mg caps and 800mg tablets. These tablets should be swallowed whole with water, not milk or calcium-containing substances. Bonefos should be taken at least two hours after meals. Patients are advised not to eat for one hour following their dose of Bonefos.

For the treatment of hypercalcaemia of malignancy (high levels of calcium in the blood caused by cancer), the suggested starting dose is 2 caps of 400 mg and 3 caps of 200mg in divided doses. This will be gradually reduced to a maintenance dose of 1 capsule of 600mg per day.

For the treatment of fragile bone caused by a secondary tumour or multiple myeloma the suggested starting dose is 1 capsule of 600mg daily as one dose or two divided doses. The maximum suggested dose is 3 caps of 200mg daily.