Pamidronate (Aredia) (The James)

Pamidronate (Aredia) (The James)

 

What is Pamidronate (pa-mi-DROE-nate) and how does it work?

Pamidronate targets certain bone destroying cells called “osteoclasts” and stops them from weakening bone any further. Pamidronate is used to prevent bone breaks (fractures), relieve pain and make bones stronger in patients whose cancer has spread to the bone.

Pamidronate may also used to treat osteoporosis (thinning of the bones) in patients who have a higher risk of bone fractures.

Pamidronate may also be used to treat a condition called “hypercalcemia of malignancy” where an increased level of calcium in the blood is caused by cancer or from bone breakdown.

 

What should I tell my doctor before starting Pamidronate?

  • If you have very low calcium in your blood (hypocalcemia).
  • If you have ever had kidney problems.
  • If you have gum or dental problems, dentures that do not fit very well, or if you have had any mouth surgery.
  • If you are pregnant or think you may be pregnant. Your doctor will talk to you about birth control while getting Pamidronate.
  • If you are breastfeeding.

 

How does my doctor decide my treatment dose?

Your treatment dose and how often you receive it will depend on the condition your doctor is treating you for, and how well your kidneys are working.

 

How will my treatment be given?

Pamidronate is given directly into your blood stream through a tube (IV) placed in your arm or chest. Pamidronate comes in a bag with tubing attached. The nurse will connect the tubing to a pump. This treatment takes 2 hours.

Your entire visit, including your doctor’s appointment and your treatment will take between 3 to 4 hours.

If you have cancer and the disease has spread to your bones, you will normally get an infusion of Pamidronate once every 28 days.

 

What are the side effects of this medicine?

Every person responds differently to treatment. Some of the more common side effects are:

  • Fever, chills, headache, weakness, bone pain, muscle and joint aches on the day that you get your infusion (these side effects usually go away within a few days and become less common with continued doses)
  • Nausea
  • Mild stomach upset or stomach pain
  • Constipation or diarrhea
  • Fatigue

 

Is there anything else I should know about this treatment?

  • This treatment can cause kidney problems, so your doctor will order a simple blood test prior to each treatment to make sure your kidneys are working properly.
  • This treatment may cause a decrease in the amount of electrolytes in your bloodstream (your doctor will check the amount of electrolytes in your blood before each treatment).
  • Patients taking Pamidronate need a certain amount of calcium and vitamin D each day. Your doctor, nurse or pharmacist will talk with you about the amount you will need to take.
  • Do not get pregnant or breastfeed while taking this medicine. Tell your doctor right away if you become pregnant.
  • Call your doctor or dentist if you are having any of the following problems:
    • Pain, swelling or numbness in the mouth or jaw
    • A heavy feeling in the jaw
    • Loose teeth
    • Any other problems with your teeth or jaw
  • Be sure to tell all of your doctors, if you are having dental procedures while receiving Pamidronate.

 

What is “Osteonecrosis of the Jaws” (ONJ)?

ONJ is a condition that some people develop while taking Pamidronate. ONJ causes ulcers (non-healing wounds) to form on the gum and often on the jaw. If this happens your doctor will give you medicine for pain and to fight infection. The risk of developing ONJ while receiving Pamidronate is extremely rare.

 

What kind of treatment is available for ONJ?

To help the ulcers heal properly, your doctor may prescribe antiseptic mouth rinses, antibiotics, or removal of dead bone from the affected area. If you develop ONJ, your doctor or dentist may send you to a specialist in oral medicine to decide on the best treatment for you.

 

What can I do to avoid ONJ?

Unless your doctor decides that you need to start treatment right away, you should have a dental exam before you receive your first dose of Pamidronate. Preventive dental care may reduce the chances of developing ONJ. Some patients may need to have teeth removed or other dental work completed before starting treatment. If this needed, your doctor will allow plenty of time for your mouth to heal before starting Pamidronate.

Assistance may be available if you cannot pay for a dental exam due to a lack of insurance. Tell your doctor if you would like information about these resources.

 

 

© May 26, 2023. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.