pamidronate

What is the most important information I should know about pamidronate?

What is pamidronate?

Pamidronate is a bisphosphonate (bis FOS fo nayt) medicine that alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Pamidronate is used to treat Paget's disease of bone. Pamidronate is also used to treat high blood levels of calcium caused by cancer (also called hypercalcemia of malignancy).

Pamidronate is also used to treat bone damage caused by certain types of cancer such as breast cancer or bone marrow cancer. Pamidronate does not treat the cancer itself.

Pamidronate may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using pamidronate?

To make sure pamidronate is safe for you, tell your doctor if you have ever had:

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
• kidney disease;
• liver disease; or
• a dental problem (you may need a dental exam before you receive pamidronate).

In rare cases, this medicine may cause bone loss (osteonecrosis) in the jaw. Symptoms include jaw pain or numbness, red or swollen gums, loose teeth, or slow healing after dental work. The longer you use pamidronate, the more likely you are to develop this condition.

Osteonecrosis of the jaw may be more likely if you have cancer or received chemotherapy, radiation, or steroids. Other risk factors include blood clotting disorders, anemia (low red blood cells), and a pre-existing dental problem.

How is pamidronate given?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Pamidronate is injected into a vein through an IV. You may be shown how to use an IV at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.

This medicine must be given slowly, and the infusion can take 2 to 24 hours to complete.

Pamidronate is sometimes given as a single dose only one time. It may also be repeated over 3 days in a row, or given once every 3 to 4 weeks. How often you receive pamidronate and the length of your infusion time will depend on why you are using this medicine. Follow your doctor's instructions.

Pamidronate is a powder medicine that must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medicine.

Your kidney function may need to be checked while you using pamidronate.

Pay special attention to your dental hygiene while using pamidronate. Brush and floss your teeth regularly. If you need to have any dental work (especially surgery), tell the dentist ahead of time that you are using pamidronate.

Pamidronate is only part of a complete program of treatment that may also include diet changes and taking calcium and vitamin supplements. Follow your doctor's instructions very closely.

Each single-use vial (bottle) of this medicine is for one use only. Throw it away after one use, even if there is still medicine left inside.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

What happens if I miss a dose?

What happens if I overdose?

What should I avoid while using pamidronate?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What are the possible side effects of pamidronate?

• high fever;
• new or unusual pain in your thigh or hip;
• a seizure;
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• low potassium --leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or
• low calcium levels --muscle spasms or contractions, numbness or tingly feeling (around your mouth, or in your fingers and toes).

Common side effects may include:

• fever, headache;
• bone pain;
• increased blood pressure;
• nausea, vomiting;
• low calcium or phosphate levels; or
• pain, redness, swelling or a hard lump under your skin around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect pamidronate?

Pamidronate can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Other drugs may interact with pamidronate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about pamidronate.