What is this medication?
Pamidronate Disodium, Aredia
Indicated for treatment of hypercalcemia of malignancy, osteolytic bone metastases of breast caner, osteolytic lesions of multiple myeloma, Paget disease.
How does this medication work?
Pamidronate Disodium, Aredia is a nitrogen-containing bisphosphonate; it inhibits bone resorption by disrupting osteoclast activity.
How should I take this medication?
Usual (IV): 60mg to 90 mg as a single dose infused over 2 to 24 hours.
Note: Single doses should not exceed 90 mg.
How to Take:
IV: Infusion rate varies by indication. Longer infusion times (>2 hours) may reduce the risk for renal toxicity, especially in patients with pre-existing renal insufficiency. The manufacturer recommends infusing over 2 to 24 hours for hypercalcemia of malignancy; over 2 hours for osteolytic bone lesions with metastatic breast cancer; and over 4 hours for Paget disease and for osteolytic bone lesions with multiple myeloma. ASCO guidelines for bisphosphonate use in multiple myeloma recommend infusing pamidronate over at least 2 hours; if therapy is withheld due to renal toxicity, infuse over at least 4 hours upon reintroduction of treatment after renal recovery; infuse over 4 to 6 hours in patients with pre-existing severe renal impairment and extensive bone disease.
What should I watch for while using this medication?
Before using Pamidronate Disodium, Aredia, make sure your physician is aware of any allergies or medications you currently take, pre-existing medical conditions and activities you perform. Atypical femur fractures (AFF) have been reported in patients receiving bisphosphonates. The fractures include subtrochanteric femur (bone just below the hip joint) and diaphyseal femur (long segment of the thigh bone). Patients receiving long-term (>3 to 5 years) bisphosphonate therapy may be at an increased risk. Pamidronate can cause severe bone, joint, and/or muscle pain. Consider discontinuing therapy in patients who experience severe symptoms; symptoms usually resolve upon discontinuation. Pamidronate has been associated with electrolyte abnormalities including hypophosphatemia, hypokalemia, hypomagnesemia, and hypocalcemia. Patients with pre-existing anemia, leukopenia, or thrombocytopenia should be closely monitored during the first 2 weeks of treatment. Osteonecrosis of the jaw (ONJ) has been reported in patients receiving bisphosphonates. ONJ is a higher risk with IV antiresorptive therapy such as pamidronate compared to oral bisphosphonate use. Single pamidronate doses should not exceed 90 mg. Initial or single doses have been associated with renal deterioration, progressing to renal failure and dialysis. Glomerulosclerosis (focal segmental) with or without nephrotic syndrome has also been reported. Pamidronate should be used with caution in patients with a history of thyroid surgery and/or hypoparathyroidism because of a higher risk of pamidronate-related hypocalcemia.
What if I miss a dose?
If you have missed a dose of Aredia, call your doctor immediately for instructions.
How should I store this medication?
Aredia reconstituted with Sterile Water for Injection may be stored under refrigeration at 36°- 46°F (2°-8°C) for up to 24 hours.
Do not store Aredia above 86°F (30°C).
What are the possible side effects of using this medication?
Fatigue, headache, insomnia, anxiety, pain, hypophosphatemia, hypokalemia, hypocalcemia, hypomagnesemia, nausea, vomiting, anorexia, abdominal pain, dyspepsia, urinary tract infection, anemia, metastases, granulocytopenia, infusion site reaction, myalgia, weakness, ostealgia, arthralgia, increased serum creatinine, dyspnea, upper respiratory tract infection, cough, sinusitis, pleural effusion, fever
Note this is not a complete list of side effects, only the most common.
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