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Pamidronate disodium

Pamidronate disodium is given by intravenous infusion in a hospital clinic.

You may feel tired or dizzy for up to 24 hours after having the infusion. You should not drive yourself home after your treatment. Do not drive and do not use tools or machines if you are affected

Your doctor may recommend that you see your dentist before you have this treatment

Take care to avoid becoming dehydrated during treatment - ask your doctor how much you should drink.

At a glance

  • Pamidronate disodium is a medicine given by injection to treat certain bone problems.

  • It can reduce bone pain and high calcium levels in cancer patients.

  • It also helps make bones stronger for people with Paget's disease of bone.

  • You will receive this medicine as a slow intravenous infusion in a hospital clinic.

  • Tell your doctor if you are pregnant, breastfeeding, or have kidney, liver, or heart conditions.

  • Good dental hygiene is important; inform your dentist about this treatment.

  • Do not drive or use machines if you feel tired or dizzy after your infusion.

Continue reading below

About pamidronate disodium

Type of medicine

Bisphosphonate

Used for

To prevent bone pain in people with cancer that has spread to the bone; to reduce high levels of calcium in the blood caused by cancer; Paget's disease of bone

Available as

Injection

Pamidronate disodium, a bisphosphonate, is prescribed for a number of different problems which affect bones. It can be prescribed to ease bone pain or to reduce hypercalcaemia associated with some cancers. It is also prescribed for people with Paget's disease of bone to prevent bone damage.

In some cancers there can be an excessive breakdown of bone. As this happens, calcium is lost from the bone and seeps into the blood, leading to higher than normal levels of calcium in the blood. This is called hypercalcaemia. Pamidronate disodium binds to bone and reduces the rate at which it is broken down. This helps strengthen bones by preventing the loss of calcium and this reduces the high levels of calcium in the blood.

In Paget's disease of bone, pamidronate disodium works on bones to make them stronger and help prevent bone thickening. This helps ease symptoms such as pain, bone damage and fracture.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start treatment it is important that your doctor knows:

  • If you are pregnant or breastfeeding.

  • If you are due to have any dental treatment in the near future, or if you have not recently had a dental check-up.

  • If you have a heart condition.

  • If you have any problems with the way your kidneys work, or the way your liver works.

  • If you have ever had any surgery on your thyroid gland.

  • If you have been told you have low amounts of calcium in your blood.

  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

  • If you have ever had an allergic reaction to a medicine.

Continue reading below

  • Before you start the treatment, ask to read the manufacturer's printed information leaflet from inside the pack. It will give you more information about pamidronate disodium and will provide you with a full list of the side-effects which you may experience from having it.

  • Pamidronate disodium will be given to you in a hospital clinic. It will be made up by the hospital staff and administered by intravenous infusion - this means that it is added into an injection fluid and injected slowly (over an hour or so) into one of your veins.

  • The number of doses you require will depend upon the reason why it has been prescribed for you. Some people require only a single dose, others require a short course of treatment.

  • It is important that you do not become dehydrated during treatment with pamidronate disodium. Your doctor will probably advise you drink a couple of glassfuls of water before and after your treatment.

  • You may feel tired or dizzy for up to 24 hours after having the infusion. You should not drive yourself home after your treatment. Do not drive and do not use tools or machines if you are affected.

  • It may be necessary for you to take tablets of calcium and vitamin D as a supplement alongside this treatment. If so, your doctor will prescribe this for you.

  • Good dental hygiene is important during treatment with this medicine - this means that you must brush your teeth regularly and have regular dental check-ups. Tell your dentist that you are having treatment with pamidronate disodium, as some dental treatments may not be recommended for you.

  • Remember to follow any lifestyle advice your doctor has given you. Eating a well-balanced diet, stopping smoking and taking regular exercise can help bones stay strong.

  • Keep your regular appointments with your doctor so your progress can be monitored. You will need to have regular blood tests during this treatment.

Continue reading below

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with pamidronate disodium. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common pamidronate disodium side-effects (these affect fewer than 1 in 10 people)

What can I do if I experience this?

Feeling sleepy or tired

Do not drive and do not use tools or machines straight after receiving treatment

Fever and flu-like symptoms, headache, other aches and pains

Ask your doctor or pharmacist to recommend a suitable painkiller, and take plenty of rest and fluids

Stomach upset (such as feeling sick (nausea), abdominal discomfort, diarrhoea or constipation)

Stick to simple foods and drink plenty of water to replace any lost fluids

Sleeping problems, rash, eye problems (such as conjunctivitis), tingling feelings, feeling flushed

If any become troublesome, speak with your doctor

Changes in heart rhythm and changes to some blood test results

Your doctor will monitor for these

Less common, but possibly serious side-effects

What should I do if I experience this?

Pain in your thigh, hip, or groin

Speak with your doctor - these can be signs of a thighbone fracture

A loose tooth, or jaw pain with swelling or numbness

Speak with your doctor - these can be signs of a problem called osteonecrosis of the jaw

Ear pain, discharge from an ear, ear infection

These could be signs of a problem called osteonecrosis of the ear. Speak with your doctor straightaway

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

Important information about all medicines

If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.

Always read the printed information leaflet that comes with your medicine.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

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Unsure about mixing medicines?

Check for possible interactions between medicines, supplements and foods before taking them together.

Frequently asked questions

What is pamidronate?

Pamidronate disodium is a type of medicine known as a bisphosphonate. It's used to treat various bone-related issues, including preventing bone pain in people with cancer that has spread to the bone, reducing high calcium levels in the blood caused by cancer, and managing Paget's disease of bone.

How does pamidronate disodium help with hypercalcaemia in cancer patients?

In some cancers, bones break down excessively, releasing calcium into the blood, which causes high calcium levels (hypercalcaemia). Pamidronate disodium works by binding to the bone and slowing down this breakdown process. This action helps to strengthen bones by preventing calcium loss and thus reduces the high levels of calcium in the blood.

How does pamidronate disodium treat Paget's disease of bone?

For Paget's disease of bone, pamidronate disodium acts on the bones to make them stronger and prevents them from thickening. This helps to alleviate symptoms such as pain, bone damage, and the risk of fracture associated with the condition.

Will I need to take other medications with pamidronate disodium?

During your treatment with pamidronate disodium, your doctor might also prescribe calcium and vitamin D supplements. This is to ensure your body maintains appropriate levels of these nutrients alongside the pamidronate treatment.

What should I do if I feel dizzy or tired after the infusion?

It is common to feel tired or dizzy for up to 24 hours after receiving the infusion. You should not drive yourself home after your treatment. If you are still affected, it's advised not to drive or operate any tools or machinery.

Are there any specific lifestyle changes I should make while on this treatment?

Your doctor may give you lifestyle advice, which is important to follow. Maintaining a well-balanced diet, stopping smoking, and engaging in regular exercise can all contribute to keeping your bones strong while you are receiving this treatment.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

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Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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