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EHDP (Etidronate or Didronel) is a first generation
bisphosphonate. It is taken by mouth in tablet form as a single daily
dose and is continued for a period of six months. Care has to be taken
that the medication is taken on an empty stomach. It can be effective
in relieving symptoms but can have stomach pains, nausea and diarrhoea
as side effects.
APD Aredia (Pamidronate) is a second generation bisphosphonate
and is proving very effective in the management of Paget's disease. It
is given usually given in hospital on a day patient basis and is administered
directly into the blood stream via a drip and depending on the dose can
be repeated over a period of several weeks. The benefits of the treatment
can last for several years but it is not possible to predict in advance
those patients who will require additional courses of treatment.
Tiludronate (Skelid) represents an important development
in the treatment of Paget's disease because, like Didronel it can be given
orally but it has a much wider margin of safety because unlike Didronel
it does not cause bone demineralisation. Like Didronel it has to be given
on an empty stomach and should be taken early in the day so the patient
can remain upright immediately after taking the tablet. The initial course
of treatment lasts for 12 weeks but can be repeated when necessary.
Actonel (Risedronate) has been awarded for
use in the UK following a number of years of successful use in the United
States.
The treatment is an oral bisphosphonate which is taken in a single daily
dose of 30mg. In common with other oral bisphosphonates it is recommended
that the medication be taken with plain water 30 to 60 minutes before
breakfast, and not to lie down for 1 hour after taking the tablets. These
precautions are necessary because the presence of food interferes with
the absorption of the drug. Lying down slows down the rate at which the
medication leaves the stomach and can result in nausea and discomfort.
Actonel is taken for a period of 60 days.
Following extensive trials in the USA, Actonel would appear to be extremely
effective at reducing alkaline phosphatase levels and reducing bone pain.
It appears to be well tolerated, causing only minimal side effects.
Actonel is available both through the hospital doctor supervising your
treatment and also direct from your GP.
The NARPD aims to support further efforts to improve the management of
Paget's disease by the development of new simple, effective drug regimes.
The NARPD firmly believes it is vital that ALL sufferers have the opportunity
to obtain the correct assessment for their condition from a specialist
with expert knowledge of Paget's disease.
Although it is over 100 years since the disease was first identified
there is still no certain cure. Some patients with very mild symptoms
and no pain will need little or no treatment beyond mild analgesia. For
those with more serve symptoms the last 10-20 years have seen significant
advances in treatment which can now effectively treat the condition.
A group of drugs known as bisphosphonates have been developed to Paget's
and other bone diseases. Three of these are currently licensed for use
in the treatment of Paget's disease and others are in development.
Paget's Disease of the Breast and Genitals
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