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Pamidronic acid (INN) or pamidronate disodium (USAN), pamidronate disodium pentahydrate is a nitrogen-containing bisphosphonate, used to prevent osteoporosis. It is marketed by Novartis under the brand name Aredia. In India, it is marketed by Curacell Biotech under the brand name Pamimed.

Uses

It is used to prevent bone loss, and treat osteoporosis. It is also used to strengthen bone in Paget's disease, to prevent bone loss due to steroid use, and in certain cancers with high propensity to bone, such as multiple myeloma. In multiple myeloma, it is usually administered as an intravenous infusion, lasting about 3 hours. The therapy is repeated monthly, and lasts for the life of the patient. Due to its ability to sequester calcium in bone, it is also used to treat high calcium levels. It is also used as an experimental treatment of the bone disorder known as Osteogenesis Imperfecta. It has been studied in the treatment of Complex Regional Pain Syndrome.^[1]

Administration

Intravenous, usually 90 mg monthly. 30 mg, 60 mg, 90 mg and for hospitals, 120 mg vials are available, mixed with mannitol.

Side effects

Common side effects include bone pain, low calcium levels, nausea, and dizziness. Osteonecrosis of the jaw is a rare complication which has been associated with the use of bisphosphonates, including pamidronate.^[2]

Pamidronate activates human γδ T cells in vitro and in vivo, which may lead to flu-like symptoms upon administration.

References

^ Kubalek, O. Fain, J. Paries, A. Kettaneh, M. Thomas (2001). "Treatment of reflex sympathetic dystrophy with pamidronate: 29 cases.". Rheumatology 40 (12): 1394–1397. doi:10.1093/rheumatology/40.12.1394. PMID 11752511.
^ Zarychanski R, Elphee E, Walton P, Johnston J (2006). "Osteonecrosis of the jaw associated with pamidronate therapy.". Am J Hematol 81 (1): 73–5. doi:10.1002/ajh.20481. PMID 16369966.

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1. 高カルシウム血症の治療 treatment of hypercalcemia
2. 多発性骨髄腫患者のビスフォスフォネート製剤の使用 the use of bisphosphonates in patients with multiple myeloma
3. 骨形成不全症：管理および予後 osteogenesis imperfecta management and prognosis
4. 乳癌による骨転移のマネージメントにおける骨吸収抑制剤 osteoclast inhibitors in the management of bone metastases from breast cancer
5. 閉経後女性における骨粗鬆症に対するビスホスホネート投与 the use of bisphosphonates in postmenopausal women with osteoporosis

English Journal

Effectiveness of pamidronate as treatment of symptomatic osteonecrosis occurring in children treated for acute lymphoblastic leukemia.

Leblicq C, Laverdière C, Décarie JC, Delisle JF, Isler MH, Moghrabi A, Chabot G, Alos N.SourceEndocrinology Service and Research Center, CHU Sainte-Justine, Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.
Pediatric blood & cancer.Pediatr Blood Cancer.2013 May;60(5):741-7. doi: 10.1002/pbc.24313. Epub 2012 Sep 21.
BACKGROUND: Osteonecrosis (ON) is a severe complication of acute lymphoblastic leukemia (ALL) treatments. Recent studies suggest that bisphosphonates might reduce pain and loss of motor function in patients with ON. We assessed the effects of pamidronate compared to standard care in patients with sy
PMID 23002054

Pamidronate treatment stimulates the onset of recovery phase reducing fracture rate and skeletal deformities in patients with idiopathic juvenile osteoporosis: comparison with untreated patients.

Baroncelli GI, Vierucci F, Bertelloni S, Erba P, Zampollo E, Giuca MR.SourcePediatric Unit I, Department of Obstetrics, Gynecology and Pediatrics, University-Hospital, Via Roma 67, 56126, Pisa, Italy, g.baroncelli@med.unipi.it.
Journal of bone and mineral metabolism.J Bone Miner Metab.2013 Apr 3. [Epub ahead of print]
Although spontaneous remission occurs in patients with idiopathic juvenile osteoporosis (IJO), permanent bone deformities may occur. The effects of long-term pamidronate treatment on clinical findings, bone mineral status, and fracture rate were evaluated. Nine patients (age 9.8 ± 1.1 years, 7 m
PMID 23549954

Risk factors for renal impairment in patients with solid tumors or multiple myeloma treated with zoledronic acid.

Cha YJ, Lee YJ.AbstractObjective: Using retrospective prescription analysis, this study aimed to investigate the risk factors for renal impairment among adult solid tumor and multiple myeloma patients who have received zoledronic acid injections in a teaching hospital over the last 4 years. Methods: We examined solid tumor and multiple myeloma patients who had received at least 1 zoledronic acid injection in a teaching hospital in Seoul with at least 2,000 beds over the 4 years between January 2008 and December 2011. The injection histories and serum creatinine levels of these patients were included in the analysis. Patients who developed renal impairment subsequent to zoledronic acid injection were identified, and the risk factors were statistically analyzed. Results: In only 1 case was zoledronic acid injection reduced as directed by the creatinine clearance guidelines. Four patients whose creatinine clearance was less than 30 ml/min were injected with zoledronic acid even though its use is contraindicated in this situation. Of the 338 research subjects, 26 developed renal impairment. The following were confirmed to be statistically significant (p < 0.05) risk factors for the development of renal impairment: serum creatinine (at first injection) of greater than 1.4 mg/dl, diabetes, hypertension, thalidomide prescription, multiple myeloma, and previous pamidronate usage. Conclusions: Based on the results of this study, renal monitoring is necessary following zoledronic acid injection. In addition, for patients with renal impairment risk factors, a risk-benefit analysis must be performed before zoledronic acid is administered, and it must be administered at an appropriate dose according to the level of renal function.
International journal of clinical pharmacology and therapeutics.Int J Clin Pharmacol Ther.2013 Apr;51(4):274-82. doi: 10.5414/CP201823.
Objective: Using retrospective prescription analysis, this study aimed to investigate the risk factors for renal impairment among adult solid tumor and multiple myeloma patients who have received zoledronic acid injections in a teaching hospital over the last 4 years. Methods: We examined solid tumo
PMID 23357846

Japanese Journal

若年者のびまん性硬化性下顎骨骨髄炎にパミドロネートが著効した1例

日本口腔外科学会雑誌 61(7), 368-373, 2015
NAID 130005107663

びまん性硬化性下顎骨骨髄炎として初発しビスフォスフォネートが著効したSAPHO症候群の1例

歯科薬物療法 34(1), 16-22, 2015
NAID 130005072784

Pamidronate treatment stimulates the onset of recovery phase reducing fracture rate and skeletal deformities in patients with idiopathic juvenile osteoporosis : comparison with untreated patients

Journal of bone and mineral metabolism 31(5), 533-543, 2013-09-30
NAID 10031201687

Related Pictures

★リンクテーブル★

リンク元	「ビスホスフォネート」「パミドロン酸」「pamidronic acid」
拡張検索	「pamidronate disodium」

「ビスホスフォネート」

Pamidronic acid
Systematic (IUPAC) name
	(3-amino-1-hydroxypropane-1,1-diyl)bis(phosphonic acid)
Clinical data
AHFS/Drugs.com	International Drug Names
MedlinePlus	a601163
Pregnancy; category	AU: B3; US: D (Evidence of risk);
Legal status	UK: Prescription-only (POM); US: ℞-only;
Routes of; administration	Intravenous
Pharmacokinetic data
Bioavailability	n/a
Protein binding	54%
Metabolism	Nil
Half-life	28 ± 7 hours
Excretion	Renal
Identifiers
CAS Registry Number	40391-99-9
ATC code	M05BA03
PubChem	CID 4674
DrugBank	DB00282
ChemSpider	4512
UNII	OYY3447OMC
KEGG	D07281
ChEMBL	CHEMBL834
Chemical data
Formula	C3H11NO7P2
Molecular mass	235.07 g/mol
	SMILES O=P(O)(O)C(O)(CCN)P(=O)(O)O;
	InChI InChI=1S/C3H11NO7P2/c4-2-1-3(5,12(6,7)8)13(9,10)11/h5H,1-2,4H2,(H2,6,7,8)(H2,9,10,11) ; Key:WRUUGTRCQOWXEG-UHFFFAOYSA-N ;
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