Pamidronate

Pamidronate is a biophosphonate drug used to correct bone metabolism, affecting the process of its mineralization and counteracting osteolysis. International nonproprietary name - Disodium pamidronate. Other trade names: Pamiredin, Pamidria, Pamired, Pamifos, Pomigara, Aredia, etc.

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Indications Pamidronate

Pamidronate is used to treat diseases associated with pathological activation of osteoclasts that destroy bone tissue:

• bone metastases of cancer;
• hypercalcemia (increased calcium content in blood plasma) of oncological etiology;
• bone lesions and hypercalcemia in myeloma;
• deforming osteitis (Paget's disease).

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Release form

The drug is available in the form of a lyophilized dry substance or concentrate (in vials of 15, 30, 60 and 90 mg) for the preparation of an injection solution.

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Pharmacodynamics

The therapeutic effect of Pamidronate is provided by its active substance - disodium pamidronate (a derivative of pamidronic acid). Due to the adsorption of calcium phosphate from the mineral and intercellular matrix of bone tissue, containing calcium in the form of hydroxyapatite crystals, disodium pamidronate significantly slows down the formation and dissolution of these crystals.

As a result, changes occur in the osteoid tissue: the process of formation of osteoclasts in the periosteum - cells that destroy bone tissue - is delayed. That is, under the influence of Pamidronate, bone resorption inherent in diseases with pathological destruction of skeletal bones is inhibited.

This helps to increase the number of osteoblasts and bone density, preventing pathological bone remodeling.

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Pharmacokinetics

No more than 54% of Pamidronate after its introduction into the blood binds to plasma proteins; the half-life from the blood is 27 hours. The remaining part of the active substance binds to hydroxyapatite crystals and accumulates in the mineral matrix of bone tissue.

The drug is not subject to biochemical transformation in the body and has no metabolites. About a third of the drug is excreted in the urine within three days after infusion; the duration of excretion of disodium pamidronate from the liver and spleen is six months, and from bone tissue - about 10 months (via the kidneys).

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Dosing and administration

Pamidronate is used only by intravenous slow infusions. The maximum course dose of the drug is 90 mg, which can be administered once or for 2-4 days in a row. The individual dosage, administration scheme and duration of use of the drug are determined by the attending physician based on the specific diagnosis.

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Use Pamidronate during pregnancy

Use during pregnancy and lactation is contraindicated. The drug is not prescribed to children under 16 years of age.

Contraindications

The use of Pamidronate is contraindicated in case of increased individual sensitivity to its active substance or other derivatives of bisphosphonic acids.

In addition, given the high probability of negative consequences, Pamidronate is not recommended for use in patients with severe forms of renal dysfunction (creatinine clearance below 30 ml/min) and hypercalcemia.

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Side effects Pamidronate

The use of this drug may cause side effects similar to flu symptoms, as well as nausea, vomiting, abdominal pain and intestinal disorders; skin rashes with itching, hyperemia; changes in blood composition; sleep disorders, increased blood pressure; muscle and joint pain, etc.

Particular attention should be paid to monitoring blood calcium levels to avoid hypo- or hypercalcemia.

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Overdose

Overdose of the drug leads to the development of hypocalcemia and the occurrence of numbness of the skin, convulsions and a decrease in blood pressure. The method for eliminating the symptoms of overdose is injections of calcium preparations.

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Interactions with other drugs

The simultaneous use of Pamidronate and the hormonal drug calcitonin should be avoided, as this leads to synergism of their action and increases the degree of reduction in blood calcium levels.

The use of other biophosphonate drugs, as well as drugs that have a toxic effect on the kidneys, simultaneously with Pamidronate is not recommended.

However, no negative consequences of the parallel use of Pamidronate with antitumor drugs were observed.

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Storage conditions

Pamidronate in an unopened bottle should be stored at room temperature not exceeding +28ºС. The prepared solution should be stored at a temperature of +2-8ºС.

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Shelf life

The shelf life is 24 months (in packaging), the ready-to-use injection solution is suitable for use within 24 hours.

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