♦Pamidronate Disodium
(pam-ee’-dro-nayt)
Aredia
Pregnancy Category C
Mechanism of Action
Believed to inhibit bone resorption by blocking the dissolution of calcium phosphate crystals in the bone.
Indications
Osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma; hypercalcemia of malignancy; Paget’s disease.
Metabolism/Excretion
Not metabolized; exclusively eliminated by the renal system. Half-life: 16 hours, then 27.3 hours.
Dosage Range
Adult
♦ Osteolytic bone metastasis of breast cancer: 90 mg as a 2-hour infusion given over 3 to 4 weeks.
♦ Osteolytic bone lesions of multiple myeloma: 90 mg as a 4-hour infusion on a monthly cycle. Patients with marked Bence-Jones proteinuria and dehydration should be adequately hydrated before the infusion.
♦ Hypercalcemia of malignancy: For moderate hyper-calcemia (corrected serum calcium 12.0 to 13.5 mg/dL), 60 to 90 mg. Give the 60-mg dose as an initial, single-dose infusion over 4 hours; give the 90-mg dose as an initial single-dose infusion over 24 hours. For severe hypercal-cemia (corrected serum calcium >13.5 mg/dL), 90 mg given as an initial, single-agent infusion over 24 hours. For hypercalcemic patients who show complete or partial response initially, treatment may be repeated, using the initial dose; 7 days should elapse before retreatment.