Pamidronato Hospira (Pamidronate Disodium)

Pamidronate disodium is used in conditions that involve abnormal bone turnover, especially those linked to cancer and endocrine disorders.

• Hypercalcaemia of malignancy: lowers elevated serum calcium levels.
• Bone metastases from solid tumours: reduces skeletal‑related events such as fractures.
• Osteolysis associated with multiple myeloma: slows disease‑related bone loss.
• Paget’s disease of bone: normalises bone remodeling activity.
• Primary hyperparathyroidism (pre‑surgical): assists in controlling calcium before surgery.

• Pamidronate binds to hydroxyapatite crystals in bone, where it is taken up by osteoclasts during resorption. The drug inhibits farnesyl pyrophosphate synthase within the mevalonate pathway, disrupting prenylation of small GTP‑binding proteins essential for osteoclast attachment, sealing, and survival, thereby reducing bone resorption.

Adverse reactions reported with pamidronate are generally related to infusion and mineral metabolism.

Common Side Effects

• Fluoro‑like symptoms (fever, myalgia, arthralgia).
• Transient hypocalcaemia.
• Nausea or vomiting.
• Mild renal function changes.
• Headache.
• Injection site discomfort.

Serious or Rare Side Effects

• Acute renal insufficiency or failure.
• Severe hypocalcaemia with tetany.
• Atypical femoral fractures.
• Osteonecrosis of the jaw.
• Anaphylactoid reactions.
• Severe electrolyte disturbances.

When using pamidronate, clinicians should assess renal function, calcium status and concomitant medications.

• Renal monitoring: check serum creatinine before each dose.
• Calcium supplementation: ensure adequate calcium and vitamin D intake.
• Hydration: maintain adequate intravenous fluid intake during infusion.
• Concomitant nephrotoxic drugs: avoid or use with caution.
• Pregnancy and lactation: contraindicated unless clearly needed.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Pamidram? 

Major Interactions (Avoid)

• Non‑steroidal anti‑inflamatory  

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