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Hypercalcaemia - Management
What treatments are given in secondary care for people with cancer-associated hypercalcaemia?
- Management of cancer-associated hypercalcaemia in secondary care usually involves:
- Intravenous fluids (saline) — this is important, particularly if renal function affected, but is rarely sufficient in isolation to control the hypercalcaemia.
- Intravenous bisphosphonates — intravenous pamidronate or zoledronic acid are preferred.
- Management of the underlying cancer (for example chemotherapy or radiotherapy).
- Other treatments that may be used include:
- Subcutaneous calcitonin — occasionally this is given if (repeated) intravenous bisphosphonates are ineffective.
- Corticosteroids — are only effective for myeloma and lymphoma.
- Furosemide — this is occasionally used in conjunction with intravenous fluids, although there are concerns about its safety and the lack of evidence of efficacy.
- Dialysis — occasionally dialysis is necessary.
- Oral bisphosphonates — are occasionally used for maintenance therapy, once the calcium level has normalized. However, they are not as effective as, and delay rather than prevent the need for, intravenous bisphosphonates.
- Subcutaneous fluids and bisphosphonates — are occasionally used.
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