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Pamidronate

    Brands

    DEA Class; Rx

    Common Brand Names; Aredia

    • Calcium Metabolism Modifiers

    Intravenous second-generation intravenous bisphosphonate
    Used primarily for hypercalcemia of malignancy and to reduce skeletal adverse events in selected cancer patients
    For other indications, more potent bisphosphonates are preferred

    Indicated for the treatment of hypercalcemia.
    For the treatment of osteolytic lesions of multiple myeloma or osteolytic bone metastases due to breast cancer.
    For the treatment of moderate to severe Paget’s disease.
    For the treatment of osteogenesis imperfecta.

    Hypersensitivity to drug, other bisphosphonates, or excipients, including mannitol

    Anemia (42.5%)

    Urinary tract infectious disease (18.5%)

    Hypokalemia (18%)

    Hypophosphatemia (18%)

    Hypocalcemia (12%)

    Hypomagnesemia (12%)

    Seizure (2%)

    Common

    • HTN

    • Fever

    • Abdominal pain, appetite loss, dyspepsia, nausea, vomiting

    • Injection site reaction

    • Bone pain

    • Cough. dyspnea, URI, sinusitis

    Serious

    • Osteonecrosis (primarily involving the jaw) reported predominantly in pts w/ cancer

    • Focal segmental glomerulosclerosis

    Bisphosphonates are incorporated into bone matrix, and gradually released over periods of weeks to years; may cause fetal harm when administered to a pregnant woman

    There are no adequate and well-controlled studies in pregnant women; therapy may cause fetal harm when administered to a pregnant woman

    It is not known whether pamidronate is excreted in human milk; because many drugs are excreted in human milk, and because of potential for serious adverse reactions in nursing infants from pamidronate disodium, a decision should be made to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

    Adults

    90 mg/dose IV.

    Geriatric

    90 mg/dose IV.

    Adolescents

    Safety and efficacy have not been established; however, 1 mg/kg/day IV for a 2- to 3-day cycle up to a usual dose range of 6 to 9 mg/kg/year IV has been used for osteogenesis imperfecta.

    Children

    Safety and efficacy have not been established; however, 1 mg/kg/day IV for a 2- to 3-day cycle up to a usual dose range of 6 to 9 mg/kg/year IV has been used for osteogenesis imperfecta.

    Infants

    Safety and efficacy have not been established; however, doses up to 1.5 mg/kg/day IV for a 2-day cycle for a total yearly dose of 12 mg/kg/year IV have been used for osteogenesis imperfecta.

    Neonates

    Safety and efficacy have not been established.

    Pamidronate disodium

    powder for reconstitution

    • 30mg

    pamidronate injection solution as disodium

    • 3mg/mL
    • 6mg/mL
    • 9mg/mL