Pamidronic acid

Pamidronic acid

Clinical data
Pregnancy category	AU: B3 US: D (Evidence of risk)
Routes of administration	Intravenous
ATC code	M05BA03 (WHO)
Legal status
Legal status	UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	n/a
Protein binding	54%
Metabolism	Nil
Elimination half-life	28 ± 7 hours
Excretion	Renal
Identifiers
IUPAC name (3-amino-1-hydroxy-1-phosphono-propyl)phosphonic acid
CAS Number	40391-99-9
PubChem CID	4674
DrugBank	APRD01161
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C3H11NO7P2
Molar mass	235.07 g/mol

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Overview

Pamidronic acid (INN) or pamidronate disodium (USAN), marketed as pamidronate disodium pentahydrate under the brand name Aredia®, is a bisphosphonate.

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.

Administration

Intravenous, usually 90 mg monthly. 30 mg, 60 mg, and 90 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.

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

References

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