Specialty Formalary
Trade Name: 
30mg, 60mg, 90mg
In Treatment of: 
It is used to prevent bone loss, and treat osteoporosis. It is also used to strengthen bone in Paget's disease, to prevent bone loss due to steroid use, and in certain cancers with high propensity to bone, such as multiple myeloma. In multiple myeloma, it is usually administered as an intravenous infusion, lasting about 3 hours. The therapy is repeated monthly, and lasts for the life of the patient. Due to its ability to sequester calcium in bone, it is also used to treat high calcium levels. It is also used as an experimental treatment of the bone disorder known as Osteogenesis Imperfecta, or brittle bones.
Adverse Effects: 
Common side effects include bone pain, low calcium levels, nausea, and dizziness. Osteonecrosis of the jaw is a rare complication which has been associated with the use of bisphosphonates, including pamidronate. Pamidronate activates human γδ T cells in vitro and in vivo, which may lead to flu-like symptoms upon administration.
Pamidronate is contraindicated in patients with clinically significant hypersensitivity to Pamidronate or other bisphosphonates.
Special Precaution: 
Before receiving pamidronate injection, 1. tell your doctor and pharmacist if you are allergic to pamidronate injection, alendronate (Fosamax), etidronate (Didronel), risedronate (Actonel), tiludronate (Skelid), zoledronic acid (Zometa), any other medications, or any of the ingredients in pamidronate injection. Ask your pharmacist for a list of the ingredients. 2. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: cancer chemotherapy medications; oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone);and thalidomide (Thalomid). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with pamidronate injection, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. 3. tell your doctor if you are being treated with radiation therapy and if you have or have ever had thyroid surgery, seizures, or liver or kidney disease. 4. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should use a reliable method of birth control to prevent pregnancy while you are receiving pamidronate. If you become pregnant while receiving pamidronate, call your doctor immediately. Talk to your doctor if you plan to become pregnant at any time in the future because pamidronate may remain in your body for years after you stop using it. 5. you should know that pamidronate may cause serious problems with your jaw, especially if you have dental surgery or treatment while you are taking the medication. A dentist should examine your teeth and perform any needed treatments before you start to receive pamidronate. Be sure to brush your teeth and clean your mouth properly while you are receiving pamidronate. Talk to your doctor before having any dental treatments while you are receiving this medication. 6. you should know that pamidronate injection may cause severe bone, muscle, or joint pain. You may begin to feel this pain within days, months, or years after you first receive pamidronate injection. Although this type of pain may begin after you have received pamidronate injection for some time, it is important for you and your doctor to realize that it may be caused by pamidronate. Call your doctor right away if you experience severe pain at any time during your treatment with pamidronate inejction. Your doctor may stop giving you pamidronate injection and your pain may go away after you stop treatment with this medication.
Concomitant administration of a loop diuretic had no effect on the calcium-lowering action of Pamidronate. Caution is indicated when Pamidronate is used with other potentially nephrotoxic drugs. In multiple myeloma patients, the risk of renal function deterioration may be increased when Pamidronate is used in combination with thalidomide.
Intravenous, usually 90 mg monthly. 30 mg, 60 mg, and 90 mg vials are available, mixed with mannitol.

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