of wonderful [5:<18 years of age. 1 2 Renal Impairment Contraindicated in patients with S cr >2.5 mg/dL. 1 Safety and efficacy in these patients have not been examined systematically. 1 If used in patients with S cr of 2 2.5 mg/dL, monitor renal function frequently. 1 Discontinue if S cr increases beyond 2.5 mg/dL. 1 Common Adverse Effects Increased BUN and S cr , hypocalcemia, transient hypophosphatemia, decreased serum bicarbonate, decreased BP. 1 Interactions for Gallium Nitrate Nephrotoxic Drugs Potential increased risk of nephrotoxicity. 1 Discontinue gallium if use of a potentially nephrotoxic drug is indicated; continue hydration for several days after administration of the nephrotoxic drug. 1 Closely monitor S cr and urine output during and after this period. 1 If S cr >2.5 mg/dL, discontinue gallium therapy. 1 Specific Drugs Drug Interaction Cyclophosphamide Dyspnea (occasionally associated with interstitial pneumonitis), mouth soreness, and asthenia reported in small number of multiple myeloma patients receiving low-dose gallium concomitantly with cyclophosphamide and prednisone 1 Diuretics (e.g., furosemide) No apparent adverse interaction 1 Gallium Nitrate Pharmacokinetics Absorption Serum Concentrations Steady state reached in 24 48 hours. 1 Elimination Metabolism Not metabolized by liver or kidneys. 1 Elimination Route Substantially excreted by kidneys. 1 Average plasma clearance: 0.15 L/hour per kg. 1 Stability Storage Parenteral Injection 20 25°C. 1 Stable for 48 hours at 15 30°C or for 7 days at 2 8°C when diluted as recommended. 1 Compatibility For information on systemic interactions resulting from concomitant use, see Interactions. Parenteral Solution Compatibility 1 Compatible Dextrose 5% in water Sodium chloride 0.9% Y-Site CompatibilityHID Compatible Acyclovir sodium Allopurinol sodium Amifostine Aminophylline Ampicillin sodium-sulbactam sodium Aztreonam Cefazolin sodium Ceftazidime Ceftriaxone sodium Cimetidine HCl Ciprofloxacin Cladribine Co-trimoxazole Cyclophosphamide Dexamethasone sodium phosphate Diphenhydramine HCl Filgrastim Fluconazole Furosemide Granisetron HCl Heparin sodium Hydrocortisone sodium succinate Ifosfamide Magnesium sulfate Mannitol Melphalan HCl Meperidine HCl Mesna Methotrexate sodium Metoclopramide HCl Ondansetron HCl Piperacillin sodium-tazobactam sodium Potassium chloride Ranitidine HCl Sodium bicarbonate Teniposide Thiotepa Ticarcillin disodium-clavulanate potassium Vancomycin HCl Vinorelbine tartrate Incompatible Cefepime HCl Cisplatin Cytarabine Doxorubicin HCl Etoposide Fluorouracil Haloperidol lactate Hydromorphone HCl Imipenem-cilastatin sodium Lorazepam Morphine sulfate Prochlorperazine edisylate Actions Exerts hypocalcemic effect by inhibiting calcium resorption from bone, possibly by reducing increased bone turnover. 1 No cytotoxic effects were seen on bone cells of animals treated with gallium. 1 Advice to Patients Risk of renal function abnormalities, hypocalcemia, and transient hypophosphatemia. 1 Importance of laboratory monitoring. 1 Importance of women informing their clinicians if they are or plan to become pregnant or plan to breast-feed. 1 Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. 1 Importance of informing patients of other important precautionary information. 1 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Gallium Nitrate Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral Injection 25 mg/mL (500 mg) Ganite Genta AHFS DI Essentials. Copyright 2017, Selected Revisions June 1, 2007. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. † Use is not currently included in the labeling approved by the US Food and Drug Administration. References 1. Genta incorporated. Ganite (gallium nitrate) injection prescribing information. Berkeley Heights, NJ; 2003 Sep. 2. Fujisawa Pharmaceutical Company: Personal communication. 3. Warrell RP Jr, Israel R, Frisone M et al. Gallium nitrate for acute treatment of cancer-related hypercalcemia: a randomized, double-blind comparison to calcitonin. Ann Intern Med . 1988; 108:669-74. [PubMed 3282463] 4. Bilezikian JP. Management of acute hypercalcemia. N Engl J Med . 1992; 326:1196-203. [PubMed 1532633] 5. Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food and Cosmetic Act as amended by the Orphan Drug Act (P.L. 97-414), to June 28, 1996. Rockville, MD; 1996 Jul. 6. Scher HI, Shipley WU, Herr HW. Cancer of the bladder. In: DeVita VT Jr, Hellman S, Rosenberg SA eds. Cancer: principles and practice of oncology. 5th ed. Philadelphia: Lippincott-Raven Publishers; 1997:1300-22. 7. McCaffrey JA, Hilton S, Mazumdar M et al. Phase II randomized trial of gallium nitrate plus fluorouracil versus methotrexate, vinblastine, doxorubicin, and cisplatin in patients with advanced transitional-cell carcinoma. J Clin Oncol . 1997; 15:2449-55. [PubMed 9196161] 8. Anon. Drugs of choice for cancer chemotherapy. Med Lett Drugs Ther . 2000; 42:83-92. [PubMed 10994034] 9. Roth BJ. Chemotherapy for advanced bladder cancer. Semin Oncol . 1996; 23:633-44. [PubMed 8893874] 10. Stadler WM, Kuzel T, Roth B et al. Phase II study of single-agent gemcitabine in previously untreated patients with metastatic urothelial cancer. J Clin Oncol . 1997; 15:3394-8. [PubMed 9363871] 11. Dreicer R, Propert KJ, Roth BJ et al. Vinblastine, ifosfamide, and gallium nitrate an active new regimen in patients with advanced carcinoma of the urothelium: a phase II trial of the Eastern Cooperative Oncology Group (E5892). Cancer . 1997; 79:110-4. [PubMed 8988734] 12. Einhorn LH, Roth BJ, Ansari R et al. Phase II trial of vinblastine, ifosfamide, and gallium combination chemotherapy in metastatic urothelial carcinoma. J Clin Oncol . 1994; 12:2271-6. [PubMed 7525884] 13. Roth BJ. Ifosfamide in the treatment of bladder cancer. Semin Oncol . 1996; 23(Suppl 6):50-5. [PubMed 8677450] 14. Crawford ED, Saiers JH, Baker LH et al. Gallium nitrate in advanced bladder cancer: Southwest Oncology Group study. Urology . 1991; 38:355-7. [PubMed 1755146] 15. Seligman PA, Crawford ED. Treatment of advanced transitional cell carcinoma of the bladder with continuous-infusion gallium nitrate. J Natl Cancer Inst . 1991; 83:1582-4. [PubMed 1960756] 16. Schultz P, Bajorin D, Kelly WK et al. Combination gallium nitrate and 5-fluorouracil for platinum-resistant metastatic transitional cell carcinoma of the bladder. Proc Annu Meet Am Soc Clin Oncol . 1993; 34:203. 17. Seidman AD, Scher HI, Heinemann MH et al. Continuous infusion gallium nitrate for patients with advanced refractory urothelial tract tumors. Cancer . 1991; 68:2561-5. [PubMed 1933802] 18. Reviewers comments (personal observations) on bladder cancer. HID. Trissel LA. Handbook on injectable drugs. 14th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2007:770-2. Next Interactions Print this page Add to My Med List More about gallium nitrate Side Effects Drug Interactions Support Group 0 Reviews Add your own review/rating Drug class: miscellaneous bone resorption inhibitors Professional resources Other brands: Ganite Related treatment guides Hypercalcemia Hypercalcemia of Malignancy> ] Guide to Weight Loss Drugs Find out everything you need to know about weight loss drugs in our prescription weight loss pill guide . FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Miscellaneous bone resorption inhibitors Related Drugs Hypercalcemia furosemide , Lasix , calcitonin , Miacalcin , Aredia , pamidronate , Fortical , Miacalcin Nasal , Endrate , More... 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