Trade Names:Aredia- Powder for injection, lyophilized 30 mg- Powder for injection, lyophilized 90 mg
Trade Names:Pamidronate Disodium- Injection 3 mg/mL- Injection 6 mg/mL- Injection 9 mg/mL
Inhibits normal and abnormal bone resorption.
Adsorbed to bone in areas of high turnover.
Renal excretion (46% unchanged). The t ½ is 28 h. Renal Cl is 49 mL/min.
Treatment of moderate to severe hypercalcemia associated with malignancy with or without bone metastases; treatment of moderate to severe Paget disease of bone; treatment of osteolytic bone lesions of multiple myeloma and bone metastases of breast cancer in conjunction with standard chemotherapy.
Treatment of postmenopausal osteoporosis; treatment of hyperparathyroidism; prevention of glucocorticoid-induced osteoporosis; management of immobilization-related hypercalcemia; reduction of bone pain in prostatic carcinoma.
Hypersensitivity to bisphosphonates.
IV For moderate, give 60 to 90 mg as an initial single-dose infusion over 2 to 24 h. For severe, give 90 mg as an initial single-dose infusion over 2 to 24 h. For retreatment, same as initial therapy, at least 7 days after initial dose.Paget DiseaseAdults
IV 30 mg/day as a 4-h infusion on 3 consecutive days for a total dose of 90 mg. For retreatment, same as initial therapy, when clinically indicated.Osteolytic Bone Metastases of Breast CancerAdults
IV 90 mg as a 2-h infusion every 3 to 4 wk.Osteolytic Bone Lesions of Multiple MyelomaAdults
IV 90 mg as a 4-h infusion on a monthly basis.
Store unopened vials below 86°F. Powder reconstituted with sterile water for injection may be stored in refrigerator (36° to 46°F) for up to 24 h. Diluted solution for infusion may be stored at room temperature for up to 24 h.
None well documented.
Calcium-containing infusion solutions (eg, Ringer's solution). Do not mix.
None well documented.
Atrial fibrillation; atrial flutter; cardiac failure; hypertension; syncope; tachycardia.
Asthenia; anxiety; fatigue; headache; insomnia; paresthesia; psychosis; somnolence.
Abdominal pain; anorexia; constipation; diarrhea; dyspepsia; GI hemorrhage; nausea; stomatitis; vomiting.
UTI; uremia; renal toxicity.
Anemia; granulocytopenia; leukopenia; neutropenia; thrombocytopenia.
Hypocalcemia; hypokalemia; hypomagnesemia; hypophosphatemia.
Arthralgia; arthrosis; back pain; bone pain; musculoskeletal pain; myalgia; osteonecrosis primarily of the jaws (postmarketing).
Coughing; dyspnea; pleural effusion; rales; rhinitis; sinusitis; upper respiratory infection.
Edema; fever; metastases; moniliasis; pain; allergic manifestations (eg, hypotension, dyspnea, angioedema, anaphylactic shock) (postmarketing).
Assess CBC, differential, hemoglobin, and hematocrit before therapy is initiated. Monitor these parameters closely for the first 2 wk of therapy if preexisting anemia, leukopenia, or thrombocytopenia is noted. Assess serum calcium, phosphate, magnesium, and potassium before and periodically during therapy.
Category D .
Safety and efficacy not established.
Hypocalcemia has occurred.
Use with caution in patients with active upper GI problems such as dysphagia (eg, difficulty swallowing), symptomatic esophageal diseases, gastritis, duodenitis, or ulcers.
Has been reported in patients with cancer receiving treatment regimens that include bisphosphonates. Risk factors include cancer chemotherapy, corticosteroid administration, and poor oral hygiene. Ensure that a dental examination is performed, and preventive dentistry is completed, before starting therapy in patient at risk for developing osteonecrosis of the jaw (eg, cancer, chemotherapy, corticosteroids, poor oral hygiene). While on treatment, avoid invasive dental procedures if possible.
Because pamidronate is excreted primarily by the kidney, the risk of adverse reactions may be increased in patients with impaired renal function. In patients receiving pamidronate for bone metastases and who have evidence of renal function deterioration, the drug should be withheld until renal function returns to baseline. Pamidronate has not been tested in patients with class Dc renal function impairment (creatinine above 5 mg/dL). Ensure that serum creatinine is assessed before each dose of pamidronate.
High fever, hypotension, hypocalcemia, transient taste perversion.
Copyright © 2009 Wolters Kluwer Health.