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 certain conditions, you may need a pamidronate dose adjustment or special
tests to safely use this medication. Before using pamidronate, tell your doctor if you have:
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.
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 miss a dose of pamidronate?
Call your doctor for instructions if you miss an appointment for your pamidronate
injection.
Where can I get more information about pamidronate?
Your pharmacist has information about pamidronate written for health professionals that you may read.
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, burning, swelling or irritation 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. Tell
your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about 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).
Before using pamidronate, tell your doctor if you have kidney disease, a history of thyroid
surgery, or if you are also taking thalidomide to treat bone marrow cancer.
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.
Some people using medicines similar to pamidronate have developed bone loss in the
jaw, also called osteonecrosis of the jaw. Call your doctor if you have symptoms such as jaw
pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery
involving the gums.
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 about all other medications you use. Many drugs (including some
over-the-counter medicines) can be harmful to the kidneys.
Serious side effects of pamidronate include fever, severe bone pain, severe joint or
muscle pain, urinating less than usual or not at all, swelling, rapid weight gain, eye pain, vision
changes, confusion, uneven heart rate, extreme thirst, muscle weakness or limp feeling, and
fainting or seizure.
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.
What other drugs will 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),
plicamycin (Mithracin), streptozocin (Zanosar), or tretinoin (Vesanoid).
You may need dose adjustments or special tests when taking any of these medications
together with pamidronate.
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 happens if I have an overdose of pamidronate?
