Products
Pamidronate is commercially available as an injectable (Aredia, generic). Aredia had been approved in many countries since 1993. Sales of Aredia were discontinued in 2016.
Structure and properties
Pamidronate is present in drugs as pamidronate disodium (C3H9NNa2O7P2, Mr = 279.0 g/mol) is present, a nitrogen-containing bisphosphonate that is soluble in water.
Effects
Pamidronate (ATC M05BA03) binds to hydroxyapatite crystals and reduces bone resorption. The effects are based on inhibition of osteoclasts. Bisphosphonates are incorporated into bone and released from it slowly over weeks to years.
Indications
- Tumor-induced hypercalcemia
- Osteolytic bone metastases in breast cancer.
- Osteolysis in multiple myeloma
Dosage
According to the professional information. The drug is administered as a slow intravenous infusion every three to four weeks, depending on the indication. It must not be given as a bolus injection.
Contraindications
Pamidronate is contraindicated in hypersensitivity, during pregnancy, and during lactation. For complete precautions, see the drug label.
Interactions
Drug-drug interactions are possible with renal toxic agents and thalidomide.
Adverse effects
The most common possible adverse effects include hypocalcemia and hypophosphatemia. Other common adverse effects include:
- Bone, joint, and muscle pain (disappears after discontinuation).
- Indigestion
- Anemia, thrombocytopenia, lymphocytopenia.
- Conjunctivitis
- Skin rash
- Reactions at the infusion site
- Atrial fibrillation, hypertension
- Hypomagnesemia and hypokalemia
Osteonecrosis of the jaws may occur, but especially in the presence of risk factors (eg, chemotherapy, glucocorticoid use, poor dental status, long-term therapy). The incidence of this side effect is not precisely known. Bisphosphonates have been associated with renal toxicity.
