| GALLIUM NITRATE
Classifications: bone resorption inhibitor; Therapeutic: bone resorption inhibitor; calcium regulator
Pregnancy Category: C
25 mg/mL injection
Exerts a hypocalcemic effect by inhibition of calcium resorption from bone, possibly by reducing the rate of bone metabolism.
Lowers calcium serum levels by inhibiting calcium resorption from bone.
Hypercalcemia of malignancy.
Paget's disease, painful bone metastases, adjuvant therapy for bladder cancer and lymphomas.
Severe renal impairment (serum creatinine >2.5 mg/dL); concurrent administration of a nephrotic drug (e.g., aminoglycosides
or amphotericin B); pregnancy (category C); lactation.
Renal function impairment. Safety and efficacy in children are not established.
Route & Dosage
Adult: IV 100200 mg/m2/d x 5 d
Adult: IV 200 mg/m2/d x 7 d
- Hydrate patient with oral or IV NS to produce a urine output of 2 L/d; maintain adequate hydration throughout treatment.
PREPARE: Continuous: Dilute each daily dose with 1000 mL NS (preferred if not contraindicated) or D5W.
ADMINISTER: Continuous: Infuse over 24 h taking care to avoid rapid infusion. Control rate with infusion pump or micro-drip device.
INCOMPATIBILITIES Y-site: Cisplatin, cytarabine, doxorubicin, haloperidol, hydromorphone.
- Do not administer concurrently with potentially nephrotoxic drugs.
- Store IV solutions at 15°30° C (59°86° F) for 48 h or refrigerated at 2°8°
C (36°46° F) for 7 d. Discard unused portions.
Adverse Effects (≥1%)CNS: Fatigue, paresthesia
, hyperthermia. CV:
Hypotension. GI: Nausea, vomiting, diarrhea,
, dysgeusia, mucositis, metallic taste. Hematologic: Anemia
, granulocytopenia, thrombocytopenia
Hypocalcemia, hypophosphatemia, hypomagnesemia. Urogenital: Nephrotoxicity
, acute renal
, maculopapular rash.
, amphotericin B, vancomycin
increase the risk of nephrotoxicity.
48 h. Duration:
414 d after discontinuation of therapy. Distribution:
Concentrates in tumors; distributed to lung, skin, muscle, and heart with high concentrations in liver and kidney; not known
if crosses placenta or is distributed into breast milk. Metabolism:
Not metabolized. Elimination:
3571% via kidneys within first 24 h. Half-Life:
Assessment & Drug Effects
- Lab tests: Monitor BUN and serum creatinine throughout therapy. Notify physician if serum creatinine exceeds 22.5 mg/dL;
discontinue drug if this occurs. Also, check baseline serum calcium and serum phosphorus; follow with assessments daily and
twice weekly, respectively.
- Note: If hypocalcemia occurs, withhold gallium nitrate and notify physician.
Patient & Family Education
- Learn S&S of hypocalcemia (see Appendix F). Notify physician immediately if any occur.