Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Belgium: Skelid; France: Skelid; Germany: Skelid; Hungary: Skelid; Luxembourg: Skelid; Netherlands: Skelid; Portugal: Skelid; Spain: Skelid; Sweden: Skelid; UK: Skelid.

North America

USA: Skelid.

Drug combinations


Tiludronate Disodium: C~7~H~7~ClNa~2~O~6~P~2~S. Mw: 362.57. (1) Phosphonic acid, [[(4-chlorophenyl)thio]methylene]bis-, disodium salt; (2) Disodium dihydrogen [[(p-chlorophenyl)thio]methylene]diphosphonate. CAS-149845-07-8 (1994).

Pharmacologic Category

Bone Resorption Inhibitors; Bisphosphonate Derivative. (ATC-Code: M05BA05).

Mechanism of action

Inhibition of normal and abnormal bone resorption. Inhibits osteoclasts through at least two mechanisms: disruption of cytoskeletal ring structure, possibly by inhibition of protein-tyrosine phosphatase, thus leading to detachment of osteoclasts from bone surface area and inhibition of osteoclast proton pump.

Therapeutic use

Treatment of Paget’s disease of bone (osteitis deformans) in patients whose level of serum alkaline phosphatase is at least twice upper limit of normal, or who are symptomatic, or who are at risk for future complications of their disease.

Pregnancy and lactiation implications

Theoretically, there may be risk of fetal harm when pregnancy follows completion of therapy. Based on limited case reports with pamidronate, serum calcium levels in newborn may be altered if bisphosphonates administered during pregnancy. Excretion in breast milk unknown (use with caution in nursing women).

Unlabeled use


Hypersensitivity to tiludronate, bisphosphonates, or any component of the formulation.

Warnings and precautions

Infrequently, severe (and occasionally debilitating) bone, joint, and/or muscle pain reported during bisphosphonate treatment. Avoid use in history of these symptoms in association with bisphosphonate therapy. May cause irritation to upper gastrointestinal mucosa. Esophagitis, dysphagia, esophageal ulcers, esophageal erosions, and esophageal stricture (rare) reported with oral bisphosphonates. Use with caution in dysphagia, esophageal disease, gastritis, duodenitis, or ulcers (may worsen underlying condition). Bisphosphonate therapy associated with osteonecrosis, primarily of jaw (observed mostly in cancer patients, but also in postmenopausal osteoporosis and other diagnoses). Invasive dental procedures should be avoided during treatment. Use with caution in mild-to-moderate renal impairment (not recommended in CrCl <30 mL/minute).



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