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Elimination of intravenously administered ibandronate in patients on haemodialysis: a monocentre open study

Raoul Bergner1, Katja Dill, Dietmar Boerner

  • 1Medizinische Klinik A, Klinikum der Stadt Ludwigshafen GmbH, Ludwigshafen, Germany. bergnerr@klilu.de

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|July 10, 2002
PubMed

Insights

Ibandronate is effectively removed by hemodialysis, with levels nearing the limit of quantification after three sessions. A monthly 1 mg dose is unlikely to cause elevated levels in patients undergoing regular hemodialysis.

Area of Science:

  • Pharmacology
  • Nephrology
  • Bone Metabolism

Background:

  • Ibandronate inhibits osteoclast-mediated bone resorption, used for osteoporosis and metastatic bone disease.
  • Pharmacokinetics of ibandronate in hemodialysis patients with renal osteopathy were previously unknown.

Purpose of the Study:

  • To investigate the removal of ibandronate from plasma via hemodialysis.
  • To determine the pharmacokinetics of ibandronate in patients with end-stage renal disease (ESRD) undergoing chronic hemodialysis.

Main Methods:

  • 12 chronic hemodialysis patients with ESRD received 1 mg of intravenous ibandronate.
  • Plasma ibandronate concentrations were measured pre- and post-dialyzer, and in dialysate during multiple dialysis sessions.

Main Results:

  • Ibandronate plasma levels decreased significantly, with 78% reduction in the first 4 hours of dialysis.
  • Hemodialysis removed approximately 36% of the administered ibandronate dose in the first session.
  • Ibandronate dialysis plasma clearance was determined to be 92+/-19 ml/min.

Conclusions:

  • Hemodialysis efficiently removes ibandronate, reducing plasma levels close to the quantification limit after three sessions.
  • A standard monthly 1 mg ibandronate dose is unlikely to lead to accumulation in patients on thrice-weekly hemodialysis.
  • Administer ibandronate after hemodialysis sessions in patients undergoing this treatment.
Abstract

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