Pamidronate

It is a boneresorption inhibitor.

Indications

Hypercalemia of malignancy, Paget’s disease, Osteolytic bone metastases of breast cancer, and Osteolytic lesions of multiple myeloma.

Dosage

Hypercalemia of malignancy: Treatment would depend on the severity as well as symptoms of hypercalcemia. In mild hypercalcemia, vigorous saline hydration alone may be sufficient. The recommended dose of pamidronate in moderate hypercalcemia (corrected serum calcium of approx. 12 to 13.5mg/dl) is 60 to 90 mg. The 60mg dose is given as an initial, single dose intravenous infusion over 24 hrs. In severe hypercalcemia (corrected serum calcium of approx. > 13.5mg/dl) is 90 mg. The 90mg dose most be given as an initial, single dose intravenous infusion over 24 hrs. Paget’s disease : The recommended dose of pamidronate in patients with moderate to severe Paget’s disease of bone is 30mg daily, administered as a 4-hour infusion on 3 consecutive days for a total dose of 90mg. Osteolytic bone of multiple myeloma : The recommended dose of pamidronate in patients with osteolytic bone lesions of multiple myeloma is 90mg, administered as a 4-hour infusion given on a monthly basis. Osteolytic bone metastases of breast cancer : The recommended dose of pamidronate in patients with osteolytic bone metastases is 90mg, administered over a 2-hour infusion given every 3-4 weeks.

Contra-Indications

Patients with clinically significant hypersensitivity to pamidronate or other biphosphonates.

Special Precautions

Standard hypercalcemia related metabolic parameters such as serum levels of calcium, phosphate, magnesium, and potassium should be carefully monitored.

Side Effects

Fluid overload, generalized pain. Hypertension. Abdominal pain, anorexia, constipation, nausea, vomiting. Urinary tract infection. Bone pain. Anaemia, hypokalemia, hypomagnesemia, hypophosphatemia.