Pamidronate disodium
Peer reviewed by Sid DajaniLast updated by Michael Stewart, MRPharmSLast updated 19 Jul 2023
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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 for bone problems.
It helps prevent bone pain, lowers high calcium levels caused by cancer, and treats Paget's disease.
It is given as a slow injection into a vein, usually in a hospital clinic.
You should not drive yourself home after treatment as you might feel tired or dizzy.
Good dental hygiene is important, and tell your dentist you are having this treatment.
Speak to your doctor if you have pain in your thigh, hip, groin, jaw pain, or a loose tooth.
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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.
Before having pamidronate disodium
Back to contentsSome 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.
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How you will be given pamidronate disodium
Back to contentsBefore 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.
Getting the most from your treatment
Back to contentsIt 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.
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Can pamidronate disodium cause problems?
Back to contentsAlong 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
Back to contentsImportant 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.

Unsure about mixing medicines?
Check for possible interactions between medicines, supplements and foods before taking them together.
Frequently asked questions
What is pamidronate disodium and how does it work to help my bones?
Pamidronate disodium is a type of medicine called a bisphosphonate. It works by binding to your bones and slowing down the rate at which bone is broken down. This helps to strengthen bones by preventing calcium loss, which is particularly useful when cancer causes high calcium levels in the blood (hypercalcaemia), or to make bones stronger and prevent thickening in Paget's disease of bone.
Why is it important to tell my doctor about my kidney or liver problems before starting pamidronate disodium?
It's important for your doctor to know if you have any kidney or liver problems because the medicine may need to be used with extra care. Your doctor will assess your condition to ensure it's safe for you to receive pamidronate disodium, as certain conditions can affect how your body processes the medication.
I'm having dental work soon. Why is this relevant to my pamidronate disodium treatment?
Good dental hygiene and informing your dentist about your pamidronate disodium treatment are very important. Some dental treatments may not be recommended for you while you are receiving this medicine. Therefore, you should tell your doctor if you are due for any dental treatment or haven't had a recent check-up before starting, and always inform your dentist that you are on pamidronate disodium.
How will I receive pamidronate disodium, and how long does the treatment take?
Pamidronate disodium is given in a hospital clinic. It will be prepared by hospital staff and administered as an intravenous infusion, meaning it's added to an injection fluid and slowly injected into one of your veins over about an hour. The number of doses you need will depend on why it has been prescribed, with some people needing only a single dose and others a short course of treatment.
I often feel tired after medical treatments. Is this normal with pamidronate disodium?
Yes, it is common to feel sleepy or tired for up to 24 hours after receiving a pamidronate disodium infusion. Because of this, you should not drive yourself home after your treatment, and you should avoid driving or operating tools and machines if you are feeling affected.
Why do I need to take calcium and vitamin D supplements with this treatment?
It may be necessary for you to take calcium and vitamin D tablets as a supplement alongside your pamidronate disodium treatment. If this is required for your specific condition, your doctor will provide you with a prescription for them.
What should I do if I experience jaw pain or a loose tooth while on pamidronate disodium?
If you experience a loose tooth, or pain in your jaw accompanied by swelling or numbness, you should speak with your doctor. These could be signs of a potentially serious problem called osteonecrosis of the jaw.
What kind of blood tests will I need during my treatment with pamidronate disodium?
During your treatment with pamidronate disodium, you will need to have regular blood tests. Your doctor will monitor your progress and also check for any changes in your blood test results, including those related to heart rhythm or other parameters, as these are sometimes affected by the medication.
Further reading and references
- Manufacturer's PIL, Pamidronate Disodium 3 mg/ml, 6 mg/ml and 9 mg/ml Sterile Concentrate; Hospira UK Ltd, The electronic Medicines Compendium. Dated February 2023.
- Medicines Complete BNF 89th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
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About the authorView full bio

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

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.
Next review due: 18 Jul 2026
19 Jul 2023 | Latest version

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