Pamidronate

Pamidronate is a prescription medication used for treating the symptoms of high blood levels of calcium caused by cancer (Hypercalcemia of Malignancy), Paget’s Disease, Osteolytic Bone Metastases of Breast Cancer, Osteolytic Bone Lesions of Multiple Myeloma.

• Pamidronate is available under the following different brand names: Aredia

Adult dosage

Powder for reconstitution

• 30mg

Pamidronate injection solution as disodium

• 3mg/mL
• 6mg/mL
• 9mg/mL

Hypercalcemia of Malignancy

Adult dosage

• Moderate hypercalcemia (ie, corrected serum calcium 12-13.5 mg/dL): 60-90 mg single-dose IV infusion over 2-24 hours
• Severe hypercalcemia (ie, corrected serum calcium above 13.5 mg/dL): 90 mg single-dose IV infusion over 2-24 hours

Paget's Disease

Adult dosage

• 250-500 mg orally every 12 hours for 10 days

Skin Infections

Adult and geriatric dosage

• 30 mg IV infused over 4 hours every day for 3 consecutive days (ie, total cumulative dose 90 mg)

Osteolytic Bone Metastases of Breast Cancer

Adult dosage

• 90 mg IV infusion over 2 hours every 3-4 weeks

Osteolytic Bone Lesions of Multiple Myeloma

Adult dosage

• 90 mg IV infusion over 4 hours every month

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Pamidronate include:

• fever,
• headache,
• bone pain,
• increased blood pressure,
• nausea,
• vomiting,
• low calcium or phosphate levels, and
• pain, redness, swelling, or a hard lump under your skin around the IV needle.

Serious side effects of Pamidronate include:

• hives,
• difficulty breathing,
• swelling of your face, lips, tongue, or throat,
• high fever,
• new or unusual pain in your thigh or hip,
• seizures,
• little or no urination,
• swelling in your feet or ankles,
• tiredness,
• shortness of breath,
• leg cramps,
• constipation,
• irregular heartbeats,
• fluttering in your chest,
• increased thirst or urination,
• numbness,
• tingling,
• muscle weakness,
• limp feeling,
• muscle spasms or contractions, and
• numbness or tingly feeling (around your mouth, in your fingers and toes).

Rare side effects of Pamidronate include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Pamidronate has severe interactions with no other drugs.
• Pamidronate has serious interactions with no other drugs.
• Pamidronate has moderate interactions with the following drugs:
  • aluminum hydroxide
  • calcium acetate
  • calcium carbonate
  • calcium chloride
  • calcium citrate
  • calcium gluconate
  • dichlorphenamide
  • sodium bicarbonate
  • sodium citrate/citric acid
  • tenofovir DF
• Pamidronate has minor interactions with the following drugs:
  • entecavir
  • foscarnet
  • teriparatide

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Pregnancy
• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Pamidronate?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Pamidronate?”

Cautions

• Associated with renal toxicity, including potential renal failure (do not exceed a single dose of 90 mg)
• Severe renal impairment, musculoskeletal pain
• Electrolyte abnormalities and myelosuppression may occur
• Increased risk of osteonecrosis of the jaw (advise patients against dental work during IV bisphosphonate treatment)
• Atypical subtrochanteric and diaphyseal femoral fractures reported with bisphosphonates; may present as thigh/groin pain in absence of trauma
• May cause fetal harm when administered to pregnant women; bisphosphonates are incorporated into the bone matrix and gradually released over periods of weeks to years

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk

Lactation

• Not known if crosses into breast milk, avoid