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Pamidronate disodium

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Pamidronate disodium is a bisphosphonate used to treat tumor-induced hypercalcemia, bone metastases, multiple myeloma, and Paget's disease of bone. It works by inhibiting bone resorption and osteoclast activity without inhibiting bone formation. It binds to hydroxyapatite crystals in bone and directly inhibits bone mineralization and dissolution. Common side effects include osteonecrosis of the jaw, musculoskeletal pain, and nephrotoxicity. It is contraindicated in patients with hypersensitivity, severe renal impairment, hypocalcemia, and pregnancy or breastfeeding. The recommended dosages vary depending on the condition being treated, with doses of 30-90 mg administered intravenously over

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Pamidronate Disodium Mechanism of Action Pamidronate disodium belongs to a class of bisphosphonates. The therapeutic activity of pamidronate disodium is attributable to its potent anti-osteoclastic activity on bone. At therapeutic doses, pamidronate disodium inhibits bone resorption apparently without inhibiting bone formation and mineralization. The predominant means by which pamidronate disodium reduces bone turnover appears to be through the local, direct antiresorptive effect of bone-bound bisphosphonate. Pamidronate disodium binds to calcium phosphate (hydroxyapatite) crystals and directly inhibits the formation and dissolution of this bone mineral component in vitro. In vitro studies indicate that pamidronate disodium is a potent inhibitor of osteoclastic bone resorption. Pamidronate disodium also suppresses the migration of osteoclast precursors onto the bone and their subsequent transformation into the mature resorbing osteoclast. INDICATIONS AND CLINICAL USE - Tumour-induced hypercalcemia following adequate saline rehydration. Prior to treatment with Pamidronate Disodium for Injection, renal excretion of excess calcium should be promoted by restoring and maintaining adequate fluid balance and urine output; - Conditions associated with increased osteoclast activity: predominantly lytic bone metastases and multiple myeloma; - Symptomatic Paget¨s disease of bone. CONTRAINDICATIONS Pamidronate Disodium for Injection is contraindicated - in patients with known or suspected hypersensitivity to pamidronate disodium for injection, to any of its components - Renal failure patients with creatinine clearance of less than 35 ml/hr - Hypocalcaemia which is not corrected - In pregnancy, in breast-feeding women. Precautions: Pamidronate sodium should not be mixed with ringer lactate solution or calcium containing solutions. Side effects and special precautions:
- Osteonecrosis of jaw - Musculoskeletal pain - Nephrotoxicity - Should not be given as IV bolus dose Dosage and administration: Dosing Guidelines for Bone Metastases and Multiple Myeloma: The recommended dose of Pamidronate Disodium for Injection for the treatment of predominantly lytic bone metastases and multiple myeloma is 90 mg administered as a single infusion every 4 weeks. However, in patients with multiple myeloma, it is recommended not to exceed 90 mg in 500 mL over 4 hours. Dosing Guidelines for Paget¨s Disease of Bone: The recommended total dose of Pamidronate Disodium for Injection for a treatment course is 180 C 210 mg. This may be administered either as 6 doses of 30 mg once a week (total dose 180 mg). Alternatively, 3 doses of 60 mg may be administered every second week, but treatment should be initiated with a 30 mg dose (total dose 210 mg) as influenza-like reactions are common only with the first infusion. Each dose of 30 mg or 60 mg should be diluted in at least 250 mL or 500 mL, respectively, of normal saline or D5W. An infusion rate of 15 mg per hour is recommended Dosing Guidelines for Tumour-Induced Hypercalcemia: A dose of 90 mg should be administered in 500 mL of infusion solution. The infusion rate should not exceed 22.5 mg/hour. Serum calcium should be strictly monitored.

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Pamidronate disodium

  • 1. Pamidronate Disodium Mechanism of Action Pamidronate disodium belongs to a class of bisphosphonates. The therapeutic activity of pamidronate disodium is attributable to its potent anti-osteoclastic activity on bone. At therapeutic doses, pamidronate disodium inhibits bone resorption apparently without inhibiting bone formation and mineralization. The predominant means by which pamidronate disodium reduces bone turnover appears to be through the local, direct antiresorptive effect of bone-bound bisphosphonate. Pamidronate disodium binds to calcium phosphate (hydroxyapatite) crystals and directly inhibits the formation and dissolution of this bone mineral component in vitro. In vitro studies indicate that pamidronate disodium is a potent inhibitor of osteoclastic bone resorption. Pamidronate disodium also suppresses the migration of osteoclast precursors onto the bone and their subsequent transformation into the mature resorbing osteoclast. INDICATIONS AND CLINICAL USE - Tumour-induced hypercalcemia following adequate saline rehydration. Prior to treatment with Pamidronate Disodium for Injection, renal excretion of excess calcium should be promoted by restoring and maintaining adequate fluid balance and urine output; - Conditions associated with increased osteoclast activity: predominantly lytic bone metastases and multiple myeloma; - Symptomatic Paget¨s disease of bone. CONTRAINDICATIONS Pamidronate Disodium for Injection is contraindicated - in patients with known or suspected hypersensitivity to pamidronate disodium for injection, to any of its components - Renal failure patients with creatinine clearance of less than 35 ml/hr - Hypocalcaemia which is not corrected - In pregnancy, in breast-feeding women. Precautions: Pamidronate sodium should not be mixed with ringer lactate solution or calcium containing solutions. Side effects and special precautions:
  • 2. - Osteonecrosis of jaw - Musculoskeletal pain - Nephrotoxicity - Should not be given as IV bolus dose Dosage and administration: Dosing Guidelines for Bone Metastases and Multiple Myeloma: The recommended dose of Pamidronate Disodium for Injection for the treatment of predominantly lytic bone metastases and multiple myeloma is 90 mg administered as a single infusion every 4 weeks. However, in patients with multiple myeloma, it is recommended not to exceed 90 mg in 500 mL over 4 hours. Dosing Guidelines for Paget¨s Disease of Bone: The recommended total dose of Pamidronate Disodium for Injection for a treatment course is 180 C 210 mg. This may be administered either as 6 doses of 30 mg once a week (total dose 180 mg). Alternatively, 3 doses of 60 mg may be administered every second week, but treatment should be initiated with a 30 mg dose (total dose 210 mg) as influenza-like reactions are common only with the first infusion. Each dose of 30 mg or 60 mg should be diluted in at least 250 mL or 500 mL, respectively, of normal saline or D5W. An infusion rate of 15 mg per hour is recommended Dosing Guidelines for Tumour-Induced Hypercalcemia: A dose of 90 mg should be administered in 500 mL of infusion solution. The infusion rate should not exceed 22.5 mg/hour. Serum calcium should be strictly monitored.