What is Pamidronate?

Pamidronate is in a group of medicines called bisphosphonates (bis FOS fo nayts). It alters the cycle of bone formation and breakdown in the body.
Pamidronate is used to treat high levels of calcium in the blood related to cancer (also called hypercalcemia of malignancy). Pamidronate is also used to treat Paget’s disease of bone.
Pamidronate is used to treat bone damage caused by certain types of cancer such as breast cancer or bone marrow cancer. Pamidronate does not treat cancer. Use all other medications your doctor has prescribed for those conditions.
Pamidronate may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Pamidronate?

You should not use this medication if you are allergic to pamidronate or to other bisphosphonates such as alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), risedronate (Actonel), tiludronate (Skelid), or zoledronic acid (Reclast, Zometa).
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use pamidronate:

• kidney disease
• a history of thyroid surgery; or
• if you are also taking thalidomide to treat bone marrow cancer

FDA pregnancy category D. Pamidronate can cause harm to an unborn baby. Do not use pamidronate without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.
It is not known whether pamidronate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Some people using medicines similar to pamidronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.
You may be more likely to develop osteonecrosis of the jaw if you have cancer or have been treated with chemotherapy, radiation, or steroids. Other conditions associated with osteonecrosis of the jaw include blood clotting disorders, anemia (low red blood cells), and dental surgery or pre-existing dental problems.

Pamidronate Side Effects

What are the possible side effects of Pamidronate?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have a serious side effect such as:

• fever
• severe joint, bone, or muscle pain
• jaw pain, numbness, or swelling
• painful or difficult urination
• urinating less than usual or not at all
• swelling, rapid weight gain
• confusion, hallucinations, unusual thoughts or behavior
• feeling like you might pass out
• pale skin, easy bruising or bleeding, flu symptoms
• seizure (convulsions)
• eye pain, vision changes, increased sensitivity to light; or
• uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling

Less serious side effects may include:

• mild heartburn or stomach upset, loss of appetite
• nausea, vomiting, stomach pain, gas, diarrhea, constipation
• runny or stuffy nose, cough
• increased sweating
• numbness or tingly feeling
• pain, redness, swelling or a hard painful lump under your skin around the IV needle
• dizziness, drowsiness, weakness, tired feeling
• mild joint or back pain; or
• headache

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pamidronate Interactions

What other drugs affect Pamidronate?

Pamidronate can be harmful to the kidneys, and these effects are increased when pamidronate is used together with other medicines that can harm the kidneys. Before taking pamidronate, tell your doctor if you are also using:

• lithium (Lithobid)
• methotrexate (Rheumatrex, Trexall)
• pain or arthritis medicines such as aspirin (Anacin, Excedrin), acetaminophen (Tylenol), diclofenac (Cataflam, Voltaren), etodolac (Lodine), ibuprofen (Advil, Motrin), indomethacin (Indocin), naproxen (Aleve, Naprosyn), and others
• medicines used to treat ulcerative colitis, such as mesalamine (Pentasa) or sulfasalazine (Azulfidine)
• medicines used to prevent organ transplant rejection, such as sirolimus (Rapamune) or tacrolimus (Prograf)
• IV antibiotics such as amphotericin B (Fungizone, AmBisome, Amphotec, Abelcet), amikacin (Amikin), bacitracin (Baci-IM), capreomycin (Capastat), gentamicin (Garamycin), kanamycin (Kantrex), streptomycin, or vancomycin (Vancocin, Vancoled)
• antiviral medicines such as adefovir (Hepsera), cidofovir (Vistide), or foscarnet (Foscavir); or
• cancer medicine such as aldesleukin (Proleukin), carmustine (BiCNU, Gliadel), cisplatin (Platinol), ifosfamide (Ifex), oxaliplatin (Eloxatin), streptozocin (Zanosar), or tretinoin (Vesanoid)

This list is not complete and there may be other drugs that can interact with pamidronate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Pamidronate?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity while you are using pamidronate.

Pamidronate Dosage

How should I take Pamidronate?

Before you receive pamidronate, your blood may need to be tested. You may also need additional blood tests on a regular basis during the first 2 weeks of treatment. Do not miss any scheduled visits to your doctor.
Pamidronate is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and can take up from 2 to 24 hours to complete.
Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to use your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of needles, IV tubing, and other items used in giving the medicine.
Pamidronate is sometimes given as a single dose only one time. It may also be repeated over 3 days in a row, or given once every 3 to 4 weeks. How often you receive this medication and the length of your infusion time will depend on the condition being treated. Follow your doctor’s instructions.
You may need to mix pamidronate with a liquid (diluent) in an IV bag before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication. Never mix pamidronate with a solution that contains calcium (such as lactated Ringer’s solution) or with other drugs in the same IV bag or line.
After mixing pamidronate with a diluent, you may store the mixture in the refrigerator and use it within 24 hours. Do not freeze. Do not use the mixed medication if it has changed colors or has any particles in it.
Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
If you do not have hypercalcemia, your doctor may want you to take calcium or vitamin D supplements by mouth while you are using pamidronate. Do not take any vitamin or mineral supplements that your doctor has not prescribed.

What happens if I overdose on Pamidronate?

Seek emergency medical attention if you think you have received too much of this medicine.
Symptoms of a pamidronate overdose are not known.

What happens if I miss a dose of Pamidronate?

Call your doctor for instructions if you miss an appointment for your pamidronate injection.
Sourced from everydayhealth.com