This medication is used to treat high blood calcium levels (hypercalcemia) that may occur with cancer. Pamidronate is also used to treat a certain type of bone disease (Paget's disease) and bone problems that may occur with certain cancers (breast cancer, multiple myeloma). Pamidronate belongs to a class of drugs known as bisphosphonates. It works by reducing the amount of calcium released from your bones into your blood.

Follow all instructions for proper mixing and dilution with the correct IV fluids. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Do not mix this drug with solutions that contain calcium (e.g., lactated Ringer's solution). If you have questions regarding the use of this medication, consult your pharmacist.

Kidney tests should be performed before each dose of pamidronate is given. Give this medication by vein as directed by your doctor.

The dosage is based on your medical condition and response to therapy. The dose should not be greater than 90 milligrams or be given over less than 2 hours. Doses that are higher than 90 milligrams, doses given too quickly, or previous use of this medication (or related drugs such as alendronate) increase the risk for kidney problems. (See also Side Effects and Precautions sections.) For high calcium levels, one dose is usually given. If needed, a repeat dose may be given after 7 days.

For Paget's disease, this drug is usually given once a day for 3 days or as directed by your doctor.

For bone problems, use as directed by your doctor.

It may take up to 7 days before the full benefit of this drug takes effect.

Learn how to store and discard needles and medical supplies safely. Consult your pharmacist for more details.

Mild fever, redness/swelling/pain at the injection site, stomach pain, loss of appetite, dizziness, headache, nausea, vomiting, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: increased or severe bone/joint/muscle pain, jaw pain, back pain, unusual weakness, unusual tiredness, fast/pounding/irregular heartbeat, numb/tingling skin, persistent sore throat with fever, unusual bruising/bleeding, change in the amount of urine, burning/painful urination, mental/mood changes (e.g., agitation, anxiety, confusion).

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking pamidronate, tell your doctor or pharmacist if you are allergic to it; or to other bisphosphonates such as alendronate, risedronate; or if you have any other allergies.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, asthma, severe loss of body water (dehydration), thyroid surgery.

Infrequently, serious jawbone problems (osteonecrosis) have occurred in people taking this medication. Most people were also using other medications or had conditions that might have caused the jawbone problem. If you have cancer, anemia, blood clotting disorders, infections/other diseases of the mouth, or poor dental hygiene, see your dentist for a full examination/treatment before you start pamidronate. Tell your dentist that you will be taking pamidronate, and make sure he or she knows of all your medications, especially corticosteroids (e.g., prednisone) and cancer chemotherapy. Also tell him or her of your entire medical history, especially of any cancer radiation treatments. Consult your dentist for more details.

Pamidronate may cause severe kidney problems or kidney failure if given improperly. Consult your doctor or pharmacist for more information. (See also How to Use section.) To help prevent harm to your kidneys, drink plenty of fluids unless otherwise directed by your doctor.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.

It is not known whether this drug passes into breast milk. Because of possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: mineral supplements (especially those containing calcium, magnesium, or phosphorus).

Also tell your doctor or pharmacist of drugs that may be harmful to your kidneys such as: aminoglycoside antibiotics (e.g., gentamicin, tobramycin), amphotericin B, cyclosporine, nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen), tacrolimus, vancomycin, certain "water pills" (loop diuretics such as bumetanide or furosemide).

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: change/decrease in amount of urine, severe muscle spasms, mental/mood changes, seizures.

Do not share this medication with others.

Lifestyle changes that help promote healthy bones include increasing weight-bearing exercise, stopping smoking, limiting alcohol, and eating well-balanced meals that contain adequate calcium and vitamin D. Since you may also need to take calcium and vitamin D supplements and make lifestyle changes, consult your doctor for specific advice.

Laboratory and/or medical tests (e.g., calcium, phosphate, and magnesium levels, albumin, serum creatinine) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

It is important to receive each dose as scheduled. If you miss a dose, contact your doctor for a new schedule.

Store the unmixed vials at room temperature between 56-86 degrees F (13-30 degrees C) away from light and moisture. This medication must be diluted with IV fluids just before use. However, the mixed vial can be refrigerated at 36-46 degrees F (2-8 degrees C) for 24 hours. Discard the mixed vial after 24 hours. Discard any unused portion of the vial. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.