The management of malignant hypercalcaemia

Malignant hypercalcaemia is a common problem for cancer clinicians. However, the management of this condition has altered substantially over the last 10 years and the condition is usually amenable to modern treatment. A number of effective pharmacological agents are available in current practice. Bisphosphonate drugs, particularly clodronate and pamidronate, are confirmed as the mainstay of modern management. Bisphosphonates are effective and well tolerated when given intravenously. Many aspects of the actions of bisphosphonates are not well understood, and knowledge of their pharmacokinetics is limited.