Dosing and uses of Ganite (gallium nitrate)
Adult dosage forms and strengths
injectable solution
- 25mg/mL (product discontinued)
Cancer-related Hypercalcemia
Discontinued by manufacturer (4/4/2012)
Premedicate to prevent hypersensitivity reactions (e.g., dexamethasone, diphenhydramine, H2 blockers)
100-200 mg/m² IV over 24 hours for 5 days; may shorten treatment if calcium levels return to normal in <5 days
Renal Impairment
Moderate renal impairment: Dose adjustment not provided by manufacturer's labeling; monitor renal status
Severe renal impairment: Contraindicated
Pediatric dosage forms and strengths
Not recommended
Ganite (gallium nitrate) adverse (side) effects
Frequency not defined
Hypotension
Confusion
Increased thirst
Lower extremity edema
Tachycardia
Hypotension
Rash
Coma
Hallucinations
Lethargy
Hypocalcemia
Hupophosphatemia
Respiratory alkalosis
Hypothermia
Anorexia, nausea, vomiting, abdominal cramping
Anemia
Leukopenia
Renal impairment
Hypocalcemia, hypophosphatemia, decreases bicarbonate
Visual/auditory disturbances
Warnings
Black box warnings
Concurrent use of gallium nitrate with other potentially nephrotoxic drugs (eg, aminoglycosides, amphotericin B) may increase the risk for developing severe renal insufficiency in patients with cancer-related hypercalcemia. If use of a potentially nephrotoxic drug is indicated during gallium nitrate therapy, gallium nitrate administration should be stopped and hydration continued for several days after administration of the potentially nephrotoxic drug.
Serum creatinine and urine output should be closely monitored during and after therapy. Discontinue therapy if the serum creatinine level exceeds 2.5 mg/dL.
Contraindications
Severe renal impairment (serum creatinine >2.5 mg/dL)
Cautions
Therapy may result in mild-to-moderate or asymptomatic hypocalcemia (discontinuation of therapy may be necessary)
Use caution in cardiovascular disease
Discontinue therapy during treatment with nephrotoxic drugs
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in milk unknown; not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Ganite (gallium nitrate)
Mechanism of action
Inhibits calcium resorption from bone by inhibiting osteoclast activity
Pharmacokinetics
Onset: 24-48 hr (initial); 5-9 (achieve normocalcemia)
Duration: 7-10 days
Steady-state: levels in 24-48 hr
Half-life: 105 hr (continuous infusion)
Vdss: 670 L/m²
Excretion: Urine (primary)
Administration
IV Preparation
Mfr recommends that the calculated daily dose of gallium nitrate injection be diluted, preferably in 1 L NS or D5W
IV Administration
Administer by slow IV infusion
Infuse over a 24 hr period
Storage
Protect from light
Protect from freezing
Do not refrigerate
