gallium nitrate (Discontinued)

Brand and Other Names:Ganite
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 25mg/mL (product discontinued)
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Cancer-related Hypercalcemia

Discontinued by manufacturer (4/4/2012)

Premedicate to prevent hypersensitivity reactions (e.g., dexamethasone, diphenhydramine, H2 blockers)

100-200 mg/m² IV over 24 hours for 5 days; may shorten treatment if calcium levels return to normal in <5 days 

Renal Impairment

Moderate renal impairment: Dose adjustment not provided by manufacturer's labeling; monitor renal status

Severe renal impairment: Contraindicated

Not recommended

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Adverse Effects

Frequency Not Defined

Hypotension

Confusion

Increased thirst

Lower extremity edema

Tachycardia

Hypotension

Rash

Coma

Hallucinations

Lethargy

Hypocalcemia

Hupophosphatemia

Respiratory alkalosis

Hypothermia

Anorexia, nausea, vomiting, abdominal cramping

Anemia

Leukopenia

Renal impairment

Hypocalcemia, hypophosphatemia, decreases bicarbonate

Visual/auditory disturbances

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Warnings

Black Box Warnings

Concurrent use of gallium nitrate with other potentially nephrotoxic drugs (eg, aminoglycosides, amphotericin B) may increase the risk for developing severe renal insufficiency in patients with cancer-related hypercalcemia. If use of a potentially nephrotoxic drug is indicated during gallium nitrate therapy, gallium nitrate administration should be stopped and hydration continued for several days after administration of the potentially nephrotoxic drug.

Serum creatinine and urine output should be closely monitored during and after therapy. Discontinue therapy if the serum creatinine level exceeds 2.5 mg/dL.

Contraindications

Severe renal impairment (serum creatinine >2.5 mg/dL)

Cautions

Therapy may result in mild-to-moderate or asymptomatic hypocalcemia (discontinuation of therapy may be necessary)

Use caution in cardiovascular disease

Discontinue therapy during treatment with nephrotoxic drugs

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Excretion in milk unknown; not recommended

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Mechanism of Action

Inhibits calcium resorption from bone by inhibiting osteoclast activity

Pharmacokinetics

Onset: 24-48 hr (initial); 5-9 (achieve normocalcemia)

Duration: 7-10 days

Steady-state: levels in 24-48 hr

Half-life: 105 hr (continuous infusion)

Vdss: 670 L/m²

Excretion: Urine (primary)

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Administration

IV Preparation

Mfr recommends that the calculated daily dose of gallium nitrate injection be diluted, preferably in 1 L NS or D5W

IV Administration

Administer by slow IV infusion

Infuse over a 24 hr period

Storage

Protect from light

Protect from freezing

Do not refrigerate

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