Tildren for Horses 500 mg, 30 mL vial

Dosing Instructions

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

What is Navicular Syndrome?

Navicular syndrome is the most common cause of chronic forelimb lameness in performance horses. Horses suffering from navicular syndrome feel pain in the heel, caused by degenerative bone lesions of the navicular bone. Clinical signs can vary, but are typically associated with a gait change or lameness, often aggravated when walking on hard ground or trotting circles.

How does Tildren work?

The active ingredient in Tildren is tiludronate disodium, a bisphosphate that achieves its effect by regulating osteoclasts in areas of excessive activity. Following IV infusion, Tildren travels through the blood stream and binds to the mineral matrix of the bone. The acidity of the remodeling environment causes the release of Tildren® from the bone matrix to the resorption space. This leads to improved bone remodeling, decreased mineral loss and alleviation of pain induced by abnormal osteolysis.

What does Treatment with Tildren look like?

Tildren (tiludronate disodium) will be administered to your horse through an intravenous infusion. It is administered over a 90-minute period. Tildren is most effective when used in conjunction with corrective farriery and a controlled exercise program. Visit with your veterinarian to learn more about management and care after Tildren has been given.

What is the efficacy of Tildren?

Tildren (tiludronate disodium) given at 1mg/kg IV, in conjunction with corrective shoeing, proved to be more effective in controlling clinical signs associated with navicular syndrome when evaluated at two months post-treatment compared to corrective shoeing alone.