Pamidronate disodium  

Brand name: AREDIA   

Generic name: Pamidronate 

Other names : Pamidronate disodium, ADP Sodium 

Therapeutic Class: Biphosphonates 

Manufacturer / Distributor: Novartis  

Availability: Pamidronate is available by prescription only  

FDA Approval - Pamidronate was approved by the US FDA (Food and Drug Administration) in 1994 for regulation of blood calcium levels and reduction of bone resorption or pain associated with certain disease such as breast cancer. 

Dosage form: Pamidronate is given by infusion into a vein (intravenous, IV)  

Indications:  Pamidronate is used to treat hypercalcemia (high blood calcium) that is associated with malignancy. The drug is shown to be effective in the treatment of hypercalcemia resulted from bone metastases.   

Pamidronate is used to treat multiple myeloma (cancer of the bone marrow) and cancer that has spread to bone from other tumors (metastatic breast cancer for example). Pamidronate is also used to reduce the process of disintegration of the bones of patients with Paget's disease of bone. 

In addition to theses malignancies above, your doctor may use Pamidronate for other medical conditions. Talk to your pharmacist or doctor for more information.  

Dosage: to prescribe an appropriate dose of Aredia, your doctor will consider your medical condition, weight, severity of the disease, and other drugs you are taking. Reaction of your body to the drug can also implicate in the choice or modification of the treatment. Whatever the dose recommended by your health care provider, it is very important that you follow the indications and take Pamidronate as indicated.  

If you have hypercalcemia (high calcium in the blood) due to the cancer, your doctor will base on the level of calcium in your blood to prescribe you an appropriate dose. In most cases, the maximum dose per treatment is one intravenous infusion of 90 mg or more in the space of 2 to 4 days.  

In the case of bone metastases and multiple myeloma, you may be recommended to take 90 mg dose of Pamidronate intravenously every 3 or 4 weeks. In general, the injection lasts 2 to 4 hours.  

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.  

Contraindication: 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 Aredia, 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: whenever possible, Pamidronate should not be administered with another bisphosphonate drug. Talk to your doctor before taking any other medicines during the treatment. In addition, it is important to talk to your doctor before taking over-the-counter or nonprescription medications such as vitamins, nutritional supplements and herbal products.   

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 
• 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.  

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