Mithramycin

Mithramycin is an anti-neoplastic antibiotic. Its major use is as an IV infusion to reduce very high levels of plasma calcium. It inhibits RNA synthesis in osteoclasts. Typically use a dose of 25 microgram per kilogram IV given over four to six hours. This dose can be repeated in 1 to 2 days if necessary. Ca++ levels start falling after 12 hours, with maximal reduction at 48-72 hours.

Hypercalcaemia recurs in days to several weeks. With repeated use, organotoxicity (kidney, liver, haematopoetic system) can become a problem.