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Pamidronate Disodium (AREDIA)

 

Warning: The use of pamidronate may infrequently result in serious side effects such as pain or sores in the jaw or mouth or symptoms related to low levels of calcium like numbness or tingling and/or muscle spasms. If you experience any of these side effects or have concerns about other side effects, consult with your health care professional immediately.

 

Indications: Pamidronate is a bisphosphonate, a class of medication used to reduce the loss of calcium from the bones and protecting the strength and density of bones. A common brand name of this medication is Aredia. It may also be known as AHPrBP Sodium or ADP Sodium. This medication is most often used to treat high levels of blood calcium resulting from certain types of cancer. It can also be used in the treatment of some kinds of bone disease, which result in soft or painful bones. 

Some specific types of cancer that this medication is used for are breast cancer which has begun to affect the bones, bone lesions which are a result of multiple myeloma, and Paget’s disease of the bone. This medication may be used to prevent some types of osteoporosis.

 

Dosage: Pamidronate is given by infusion into a vein (intravenous, IV). This medication is generally administered in a maximum dose of 90 milligrams. The amount of the dosage will be determined by the type of condition being treated, tests prescribed by your doctor, including blood tests, and the effectiveness of the treatment. It is a liquid medication that is injected into the vein slowly over two hours or more and possibly up to 24 hours depending on the instructions of the doctor and the condition for which the treatment is being prescribed.

The most common treatment scenarios involving pamidronate include a single dose for high levels of blood calcium, multiple spaced doses over a long period of time for bone problems resulting from cancer, and a course of three treatments over three days to treat Paget’s disease. These treatments are given by a medical professional in an office, a clinic or the hospital. While being treated with this medication, be sure to stay well hydrated and to urinate frequently.

 

In some rare situations, you may be administering this medication in your own home. If this is the case, take care to study the instructions provided by the pharmacist and your prescribing doctor. Always inspect the drug for discoloration or foreign objects. Do not use the medication if either appears.

 

Overdose: although almost nonexistent, overdose of Pamidronate can occur. If that happens, contact your doctor or emergency room immediately; they will make an intravenous infusion of calcium in your body to eliminate or reduce symptoms. Symptoms of Pamidronate overdose include: 

  • fever  
  • hypotension  
  • change in taste.  

Missing dose: if you missed a dose of Aredia, talk to your doctor to know what you should do. Your doctor may advise you to take or completely skip the missed dose. Taking chemotherapy drugs is a serious health concern; contact your doctor before the date schedule for the therapy if you cannot go to the hospital for the treatment. Do not stay home because you are experiencing side effects; Pamidronate cause side effects in most patients.  

Contraindications: Caution should be taken before using pamidronate if you have recently undergone dental procedures or if you are planning any procedures. Poor dental hygiene, dentures or some medical conditions might increase the risk of serious problems with the jawbone.

Pamidronate is contraindicated in cases of allergy to one of its constituents. Tell your doctor or pharmacist about any history of allergy to: 

  • skelid (tiludronate
  • etidronate (Didronel)  
  • alendronate (Fosamax
  • risedronate (Actonel)
  • Zoledronic acid (Zometa).  

Pamidronate is contraindicated in pregnancy or breastfeeding. See your doctor immediately if you become pregnant during the treatment; Pamidronate can cause serious problems to the fetus.  

Before taking the medication, tell your doctor if you have or had a history of thyroid surgery, seizures, liver or kidney disease, thyroid surgery or dental surgery. These factors may obligate him to prescribe another drug or change the way you should use the drug.  

Mechanism of Action (MOA): Pamidronate contributes to slowing bone loss, increasing bone density (thickness) and decreasing the amount of calcium released from bones into the blood. 

Interactions: This medication may create problems when combined with other drugs. Always provide your pharmacist and doctor with a list of other medications and supplements you are taking, including non-prescription medicines and any herbal supplements.

 

Side effects: Pamidronate may cause side effects which can be mild or severe, temporary or permanent. Most common Pamidronate side effects include:      

  • coughing
  • constipation
  • diarrhea
  • nausea and vomiting
  • heartburn
  • difficulty sleeping
  • abdominal or stomach pain
  • bone pain
  • dizziness
  • indigestion
  • loss of appetite
  • swelling of your hands, arms, feet, ankles, or lower legs
  • difficulty or painful urination
  • fatigue or general weakness
  • Pain, redness, or swelling at the injection site 

Although rare, Pamidronate can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms: 

  • shortness of breath
  • eye pain or tearing  
  • fast heartbeat 
  • sudden high blood pressure
  • fainting 
  • vomiting blood (bloody vomit) 
  • jaw numbness and pain 
  • painful or swollen gums 
  • loosening of the teeth 
  • bloody or black and tarry stools 
  • sudden tightening of muscles 
  • Numbness or tingling around your mouth or cheeks.  

 

References: 

 

wikipedia.org, Bisphosphonate