No

Antidote

Treatment of clearly symptomatic cancer-related hypercalcemia that has not responded to adequate hydration

C

Should not be used in patients with a serum creatinine >2.5 mg/dL, hypersensitivity to any component

Safety and efficacy in children have not been established. Concurrent use of gallium nitrate with other potentially nephrotoxic drugs may increase the risk for developing severe renal insufficiency in patients with cancer-related hypercalcemia; use with caution in patients with impaired renal function or dehydration

>10%:

Endocrine & metabolic: Hypophosphatemia

Gastrointestinal: Nausea, vomiting, diarrhea, metallic taste

Renal: Renal toxicity

1% to 10%: Endocrine & metabolic: Hypocalcemia

<1%: Anemia, optic neuritis, hearing impairment

Symptoms of overdose include nausea, vomiting, renal failure, hypocalcemia, tetany

Supportive measures ensure adequate hydration, calcium salts

Increased toxicity: Nephrotoxic drugs (eg, aminoglycosides, amphotericin B)

Store at room temperature (15°C to 30°C/59°F to 86°F); when diluted in NS or D₅W, stable for 48 hours at room temperature or 7 days at refrigeration (2°C to 8°C/36°F to 46°F)

Primarily via inhibition of bone resorption with associated reduction in urinary calcium excretion. Gallium has increased the calcium content of newly mineralized bone following short-term treatment in vitro, and this effect combined with its ability to inhibit bone resorption has suggested the use of gallium for other disorders associated with increased bone loss.

Metabolism: Not metabolized by liver or kidneys

Half-life, elimination: Terminal: 25-111 hours

Elimination: Up to 70% of dose excreted by the kidneys

Adults:

Mild hypercalcemia/few symptoms: 100 mg/m²/day for 5 days in 1 L of NS or D₅W

Dosing adjustment/comments in renal impairment: Cl_cr <30 mL/minute: Avoid use

Serum creatinine, BUN, and calcium

Steady-state gallium serum levels: Generally obtained within 2 days following initiation of continuous I.V. infusions of gallium nitrate

None reported

None reported

Patients should have adequate I.V. hydration, serum creatinine levels should be monitored during gallium nitrate therapy

Injection: 25 mg/mL (20 mL)

"Hazards of Gallium for Treatment of Paget's Disease of Bone," Lancet, 1990, 335(8687):477.

Samson MK, Fraile RJ, Baker LH, et al, "Phase I-II Clinical Trial of Gallium Nitrate (NSC-15200)," Cancer Clin Trials, 1980, 3(2):131-6.

Warrell RP Jr, Coonley CJ, Straus DJ, et al, "Treatment of Patients With Advanced Malignant Lymphoma Using Gallium Nitrate Administered as a Seven-Day Continuous Infusion," Cancer, 1983, 51(11):1982-7.