Pamidronate - Uses, Side Effects, and More

What are the most common side effects of pamidronate?

The most common side effects of pamidronate are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Fever
• Nausea
• Anorexia 
• Fatigue
• Flu-like symptoms 
• Stomach pain or indigestion 
• Headache
• Bone, joint, or muscle pain (see below)

There may be other side effects of pamidronate that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of pamidronate?

While less common, the most serious side effects of pamidronate are described below, along with what to do if they happen.

Severe Allergic Reactions. Pamidronate may cause allergic reactions, which can be serious. Stop using pamidronate and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Kidney Damage. Kidney damage can happen when taking pamidronate. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

Low Calcium Level (Hypocalcemia). Pamidronate can cause low calcium levels, also known as hypocalcemia, which can be serious. Decreased calcium levels can cause a rare dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium, or who take some medicines for other heart rhythm problems. Call your healthcare provider if you have any of the following symptoms.

• Changes in your heart rate or rhythm, such as fast or skipping heartbeat
• Fainting
• Numbness, tingling, or burning sensation in your arms, feet, or face (paresthesia)
• Muscle pain, spasms, twitching, or cramps
• Seizures

Severe Pain in the Bones, Joints, or Muscles. Pamidronate may cause severe pain in the bones, joints, or muscles (musculoskeletal pain). The pain can be severe enough that it could be difficult to carry out normal activities. Call your healthcare provider if you experience severe pain while on pamidronate.

Severe Jawbone Problems (Osteonecrosis). Pamidronate can rarely cause severe jawbone problems, also called osteonecrosis of the jaw. In this condition, your jawbone may get damaged due to reduced blood flow. You may be at higher risk if you are undergoing certain dental procedures (such as a tooth extraction or dental implants), if you have poor oral health, or if you have cancer or certain other conditions. You may be told to see a dentist before starting pamidronate and to practice good mouth care. Call your healthcare provider right away if you experience any of the following symptoms of jaw osteonecrosis.

• Jaw pain or discomfort
• Mouth sores
• Loose teeth

Unusual Thigh Bone Fractures. Pamidronate may cause an increased risk for fractures in your thigh bone, even with a light force. Call your healthcare provider if you experience new or unusual pain in your thigh, hip, or groin.