| name | Pamidronate |
| classification | Bisphosphonate |
| pharmacokinetics | Pamidronate is primarily absorbed in the gastrointestinal tract. Significant first-pass hepatic metabolism occurs. It is distributed throughout the body, primarily into bone tissue. Excretion is primarily renal. The half-life is variable, depending on the dose and route of administration. |
| suggested dosage | Dosage varies significantly based on the indication. Consult a physician for specific recommendations. Oral administration is less common; intravenous administration is more frequent. |
| indications | | 1 | Treatment of Paget's disease of bone | | 2 | Treatment and prevention of skeletal complications of malignancy (hypercalcemia of malignancy, osteolytic bone lesions) | | 3 | Treatment of osteoporosis |
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| safety in pregnancy | Pamidronate is not recommended for use during pregnancy unless the potential benefit outweighs the potential risks. Insufficient data exists to assess risk in pregnant women. Consult with a specialist. |
| safety in breastfeeding | Limited data on excretion into breast milk is available. Potential risk to nursing infants is unknown. Discontinue breastfeeding or the drug, as appropriate. Consult with a physician. |
| side effects | | 1 | Gastrointestinal upset (nausea, vomiting, diarrhea) | | 2 | Headache | | 3 | Myalgia (muscle pain) | | 4 | Arthralgia (joint pain) | | 5 | Bone pain | | 6 | Phlebitis (inflammation of the vein) at the IV injection site | | 7 | Renal impairment (especially with higher doses or prolonged use) | | 8 | Osteonecrosis of the jaw (ONJ) - a serious rare side effect, risk factors include prior radiation to the head and neck, dental disease, corticosteroid use, and poor oral hygiene |
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| alternatives | |
| contraindications | | 1 | Hypersensitivity to pamidronate or other bisphosphonates | | 2 | Severe renal impairment | | 3 | Hypocalcemia | | 4 | Presence of active esophageal disease or difficulty in swallowing |
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| interactions | | 1 | Simultaneous use with other nephrotoxic drugs may increase the risk of renal injury. | | 2 | Can potentially interfere with the absorption of certain medications, but this is less of a concern for IV administration. |
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| warnings and precautions | | 1 | Administer oral pamidronate with a full glass of water and remain upright for at least 30 minutes after ingestion to reduce esophageal irritation. | | 2 | Monitor renal function, particularly with prolonged or higher doses. | | 3 | Monitor serum calcium levels during therapy. | | 4 | Carefully consider the risk of osteonecrosis of the jaw in patients with dental disease. |
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| additional informations | | 1 | This information is for educational purposes only and does not constitute medical advice. Always consult a healthcare professional for diagnosis and treatment. | | 2 | Patient age and weight are generally not direct factors in determining dosing for pamidronate. Appropriate dosage is dependent upon the specific condition being treated, and other patient factors. Consult with a physician. |
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