A single dose of Tildren should be administered as an intravenous infusion at a dose of 1 mg/kg (0.45 mg/lb). The infusion should be administered slowly and evenly over 90 minutes to minimize the risk of adverse reactions. Maximum effect may not occur until 2 months post-treatment.
Sterile powder (not reconstituted): Store at controlled room temperature 68-77° F (20-25° C).
After preparation, the infusion should be administered either within 2 hours of preparation, or it can be stored for up to 24 hours under refrigeration at 36-46° F (2-8° C) and protected from light.
Step 1: Preparation of the reconstituted solution (20 mg/mL). Tildren should be reconstituted using strict aseptic technique. Remove 25 mL of solution from a 1 liter bag of sterile 0.9% Sodium Chloride Injection, USP and add it to one vial of Tildren. Shake gently until the powder is completely dissolved. This reconstituted solution contains 20 mg of tiludronate disodium per mL. After reconstitution further dilution is required before administration.
Step 2: Preparation of the solution for infusion. Using strict aseptic technique, withdraw the appropriate volume of the reconstituted solution based on the horse’s body weight (see Table 1 below). Inject that volume back into the 1 liter bag of sterile 0.9% Sodium Chloride Injection, USP. Horses greater than 1,210 lbs. will require a second vial of reconstituted Tildren solution. Invert the infusion bag to mix the solution before infusion. Label the infusion bag to ensure proper use.After preparation, the infusion should be administered either within 2 hours of preparation, or it can be stored for up to 24 hours under refrigeration at 36-46° F (2-8° C) and protected from light.
Step 3: Administer for infusion through a suitable intravenous catheter inserted into a jugular vein and connected to the infusion bag using sterile disposable infusion tubing.
Do not reconstitute or mix Tildren with calcium containing solutions or other solutions containing divalent cations such as Lactated Ringers as it may form complexes with these ions
|Weight Range (lbs)
||Volume of Reconstituted Tildren Solution to be Added to the Infusion Bag (20 mg/mL)
||30 mL (25 mL* + 5 mL from additional vial)
||35 mL (25 mL* + 10 mL from additional vial)
||40 mL (25 mL* + 15 mL from additional vial)