Pamidronate

Pamidronate (brand name Aredia) belongs to a family of drugs known as bisphosphonates. Bone is a living tissue and at any one time there is a balance between new bone being formed and old bone being broken down. Bisphosphonates slow down the rate at which old bone is broken down.

Why is pamidronate prescribed?

Pamidronate is available for the treatment of osteoporosis and Paget's disease. Because it is given by injection, pamidronate is often used for people who are unable to tolerate other bisphosphonate drugs that are taken by mouth.

• Osteoporosis Osteoporosis may occur in women following the menopause and in both men and women who are being given corticosteroids for rheumatic or other medical conditions. Pamidronate is used to prevent fractures in people who have osteoporosis
• Paget's disease Pamidronate is also used to reduce pain and disease activity in people who have Paget's disease, which gives rise to enlarged, but weakened, bones.

In addition, pamidronate can be used to reduce high blood calcium levels, which may occur in a number of conditions, including some types of cancer. In some people with cancer it is also used to treat bone disease and to help relieve bone pain.

When and how do I take pamidronate?

Pamidronate is given by very slow injection into a vein (intravenous infusion). These infusions are given under supervision at your hospital. The infusion will last from 1 hour to several hours depending on the dose. The dose and frequency of infusions depends on the condition being treated.

• Osteoporosis For the treatment of osteoporosis, infusions are usually given every 3 months. They may be continued long-term if necessary
• Paget's disease Your doctor will decide upon the number of infusions to be given for Paget's disease. Usually the course of infusions will last from 4 to 8 weeks. The course of infusions can be repeated if the Paget's disease flares up again.

In addition, your doctor may recommend that you take supplements of calcium and vitamin D when you are on pamidronate.

How long does pamidronate take to work?

• Osteoporosis In people having pamidronate for osteoporosis bone density is likely to increase within 12 months
• Paget's disease Most people who are prescribed pamidronate for Paget's disease will experience benefit within 3–6 months.

What are the possible risks or side-effects?

The most common side-effect is a mild fever which occurs at the start of treatment and lasts for 24–48 hours. Occasionally, flu-like symptoms such as a sore throat, shivering, flushes and a high temperature may occur.

Some people may experience:

• a temporary increase in pain in the bones or muscles
• mild nausea (feeling sick)
• headaches
• mild eye inflammation
• pain, redness or swelling at the infusion site.

Very rarely, people may experience a severe allergic reaction to this drug. The symptoms can include chest tightness, breathing difficulties, a rash, swelling of the face or tongue, and a drop in blood pressure. If this happens, urgent medical attention is required. If the reaction is severe, then treatment cannot be continued.

What other treatments could be used instead of pamidronate?

A number of other drugs are used in the treatment of bone disorders.  Your doctor will discuss these other options with you.

Will I need any special checks while on pamidronate?

• Osteoporosis If you are being treated for osteoporosis your doctor may arrange for your bone density to be measured.
• Paget's disease When treated for Paget's disease you will have a blood test before and after the course of treatment to check how you have responded to it. You may also have a test called an isotope bone scan, which is helpful in showing which bones are affected.

In both conditions you may have your blood calcium levels checked to make sure that the levels are within the normal range.

Can I take other medicines along with pamidronate?

Some drugs interact with pamidronate, so you should discuss any new medications with your doctor before starting them, and you should always tell any other doctor treating you that you are on pamidronate.

Pamidronate is not a painkiller. If you are already on a non-steroidal anti-inflammatory drug (NSAID) or painkillers you can carry on taking these as well as pamidronate, unless your doctor advises otherwise.

Do not take over-the-counter preparations or herbal remedies without discussing this first with your doctor, rheumatology nurse specialist or pharmacist.

What about immunisations?

You can have immunisations while on pamidronate.

Can I drink alcohol while on pamidronate?

There is no particular reason to avoid alcohol while on pamidronate. However, excessive amounts of alcohol can lead to further weakening of the bones in people who already have osteoporosis.

Does pamidronate affect fertility or pregnancy?

You should not have pamidronate during pregnancy. If you are planning a family or if you become pregnant while on pamidronate, you should discuss this with your doctor as soon as possible.

What about breastfeeding?

You should not breastfeed if you are on pamidronate. The drug may pass into the breast milk and could be harmful to your baby.

Where can I obtain further information?

If you would like any further information about pamidronate, or if you have any concerns about your treatment, you should discuss this with your doctor, rheumatology nurse or pharmacist.

 

Remember to keep all medicines out of reach of children.

PLEASE NOTE: We have made every effort to ensure that this content is correct at time of publication, but remember that information about drugs may change. This page is for general education only and does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet that comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects that may be relevant in your particular case.

Our drug information is revised annually and published at the start of the year.