Select therapeutic use:

Bone disorders:

Indications for Pamidronate disodium Injection:

Paget's disease.

Adult:

Give by IV infusion. 30mg daily infused over 4hrs on 3 consecutive days for a total of 90mg.

Children:

Not recommended.

Warnings/Precautions:

Severe renal impairment in patients with bone metastases: not recommended. Renal or hepatic insufficiency. Check serum creatinine before each dose: withhold until serum creatinine is within 10% of baseline if serum creatinine increases 0.5mg/dL from normal pre-treatment levels, or by 1mg/dL from an abnormal pre-treatment level. Monitor electrolytes (esp. calcium, magnesium, phosphate, potassium), CBC/differential, hematocrit/hemoglobin. Pre-existing blood disorders (eg, anemia, leukopenia, thrombocytopenia); monitor closely for first 2 weeks after treatment. Avoid dental surgery (do preventative dental work before therapy). Evaluate if thigh or groin pain develops and consider discontinuing if atypical femur fracture is suspected. Pregnancy (Cat.D): not recommended. Nursing mothers.

Pharmacologic Class:

Bisphosphonate.

Interactions:

Caution with other nephrotoxic drugs (eg, thalidomide).

Adverse Reactions:

Infusion-site reactions, fever, headache, dizziness, paresthesia, increased sweating, GI upset, anemia, fatigue, musculoskeletal pain (may be severe), electrolyte disturbances, hypertension, dyspnea, renal toxicity; jaw osteonecrosis, atypical subtrochanteric and diaphyseal femoral fractures.

How Supplied:

Contact supplier.

Breast cancer:

Indications for Pamidronate disodium Injection:

Osteolytic bone metastases of breast cancer.

Adult:

Give by IV infusion. 90mg infused over 2hrs every 3–4wks. Max single dose: 90mg.

Children:

Not recommended.

Warnings/Precautions:

Severe renal impairment in patients with bone metastases: not recommended. Renal or hepatic insufficiency. Check serum creatinine before each dose: withhold until serum creatinine is within 10% of baseline if serum creatinine increases 0.5mg/dL from normal pre-treatment levels, or by 1mg/dL from an abnormal pre-treatment level. Monitor electrolytes (esp. calcium, magnesium, phosphate, potassium), CBC/differential, hematocrit/hemoglobin. Pre-existing blood disorders (eg, anemia, leukopenia, thrombocytopenia); monitor closely for first 2 weeks after treatment. Avoid dental surgery (do preventative dental work before therapy). Evaluate if thigh or groin pain develops and consider discontinuing if atypical femur fracture is suspected. Pregnancy (Cat.D): not recommended. Nursing mothers.

Pharmacologic Class:

Bisphosphonate.

Interactions:

Caution with other nephrotoxic drugs (eg, thalidomide).

Adverse Reactions:

Infusion-site reactions, fever, headache, dizziness, paresthesia, increased sweating, GI upset, anemia, fatigue, musculoskeletal pain (may be severe), electrolyte disturbances, hypertension, dyspnea, renal toxicity; jaw osteonecrosis, atypical subtrochanteric and diaphyseal femoral fractures.

How Supplied:

Contact supplier.

Cytoprotective and supportive care agents:

Indications for Pamidronate disodium Injection:

Hypercalcemia of malignancy.

Adult:

Give by IV infusion. Assure adequate hydration; give as a single dose infused over 2–24hrs; moderate disease (albumin-corrected serum calcium 12–13.5mg/dL): 60–90mg; severe disease (albumin-corrected serum calcium >13.5mg/dL): 90mg; allow at least 7 days before retreating. Max single dose: 90mg.

Children:

Not recommended.

Warnings/Precautions:

Severe renal impairment in patients with bone metastases: not recommended. Renal or hepatic insufficiency. Check serum creatinine before each dose: withhold until serum creatinine is within 10% of baseline if serum creatinine increases 0.5mg/dL from normal pre-treatment levels, or by 1mg/dL from an abnormal pre-treatment level. Monitor electrolytes (esp. calcium, magnesium, phosphate, potassium), CBC/differential, hematocrit/hemoglobin. Pre-existing blood disorders (eg, anemia, leukopenia, thrombocytopenia); monitor closely for first 2 weeks after treatment. Avoid dental surgery (do preventative dental work before therapy). Evaluate if thigh or groin pain develops and consider discontinuing if atypical femur fracture is suspected. Pregnancy (Cat.D): not recommended. Nursing mothers.

Pharmacologic Class:

Bisphosphonate.

Interactions:

Caution with other nephrotoxic drugs (eg, thalidomide).

Adverse Reactions:

Infusion-site reactions, fever, headache, dizziness, paresthesia, increased sweating, GI upset, anemia, fatigue, musculoskeletal pain (may be severe), electrolyte disturbances, hypertension, dyspnea, renal toxicity; jaw osteonecrosis, atypical subtrochanteric and diaphyseal femoral fractures.

How Supplied:

Contact supplier.

Leukemias, lymphomas, and other hematologic cancers:

Indications for Pamidronate disodium Injection:

Osteolytic lesions of multiple myeloma.

Adult:

Give by IV infusion. 90mg infused over 4hrs once monthly. Max single dose: 90mg.

Children:

Not recommended.

Warnings/Precautions:

Severe renal impairment in patients with bone metastases: not recommended. Renal or hepatic insufficiency. Check serum creatinine before each dose: withhold until serum creatinine is within 10% of baseline if serum creatinine increases 0.5mg/dL from normal pre-treatment levels, or by 1mg/dL from an abnormal pre-treatment level. Monitor electrolytes (esp. calcium, magnesium, phosphate, potassium), CBC/differential, hematocrit/hemoglobin. Pre-existing blood disorders (eg, anemia, leukopenia, thrombocytopenia); monitor closely for first 2 weeks after treatment. Avoid dental surgery (do preventative dental work before therapy). Evaluate if thigh or groin pain develops and consider discontinuing if atypical femur fracture is suspected. Pregnancy (Cat.D): not recommended. Nursing mothers.

Pharmacologic Class:

Bisphosphonate.

Interactions:

Caution with other nephrotoxic drugs (eg, thalidomide).

Adverse Reactions:

Infusion-site reactions, fever, headache, dizziness, paresthesia, increased sweating, GI upset, anemia, fatigue, musculoskeletal pain (may be severe), electrolyte disturbances, hypertension, dyspnea, renal toxicity; jaw osteonecrosis, atypical subtrochanteric and diaphyseal femoral fractures.

How Supplied:

Contact supplier.