Pamidronate
A DRUG Information Sheet
Why I am being prescribed pamidronate?
Pamidronate (brand name Aredia) belongs to a family of drugs known as bisphosphonates, which are prescribed 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 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.
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.
For the treatment of osteoporosis, infusions are usually given every 3 months. They may be continued long-term if necessary.
For Paget's disease, your doctor will decide upon the number of infusions to be given. Usually the course of infusions will last from 4–8 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 will pamidronate take to work?
Most people who are prescribed pamidronate for Paget's disease will experience benefit within 3–6 months. In people receiving pamidronate for osteoporosis bone density is likely to increase within 12 months.
What are the possible risks or side-effects?
This medicine sometimes causes unwanted effects in some people. 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.
Pamidronate can sometimes cause an increase in pain in your bones or muscles, but this is temporary. Some people complain of mild nausea and headaches. Mild inflammation of the eye can occur. Pain, redness or swelling at the infusion site can also occur.
Very rarely, some people may experience a severe allergic reaction to the drug. The symptoms of this are chest tightness, breathing difficulties, a rash, and a drop in blood pressure. As the pamidronate infusions are given under medical supervision, this allergic reaction can be easily treated.
What other treatments could be used instead of pamidronate?
A number of other drugs are used in the treatment of bone disorders (see arc leaflets 'Drugs and Arthritis', 'Drugs for Osteoporosis'). Your rheumatologist will discuss these other options with you.
Do I need any special checks while on pamidronate?
If you are being treated for osteoporosis your doctor may arrange for your bone density to be measured.
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.
In both conditions you may have your blood calcium levels checked.
May 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 being prescribed pamidronate.
Pamidronate is not a painkiller. So if you are on a painkiller or a non-steroidal anti-inflammatory drug (NSAID) you may carry on taking these as well as pamidronate, unless your doctor advises otherwise.
Do not take over-the-counter preparations without discussing this first with your doctor, rheumatology nurse specialist or pharmacist.
Can I have immunisations while on pamidronate?
Yes, you can have immunisations while being treated with pamidronate.
May I drink alcohol while on pamidronate?
There is no particular reason for you 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 pregnancy?
You should not receive 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 being prescribed pamidronate.
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 the content of this information sheet is correct at time of going to press, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.
