Disodium pamidronate (Aredia)
This page tells you about the bisphosphonate drug disodium pamidronate and its possible side effects. There is information about
Pamidronate is a type of bisphosphonate. It is also called Aredia. Doctors use it to treat cancers that break down bone cells or that have spread into the bones, in particular
- Secondary breast cancer
- Secondary prostate cancer
Pamidronate is a clear liquid that goes into your vein as a drip (infusion). You can have it through a thin, short tube (cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.
The drip lasts from one to several hours, depending on the dose.
You may have pamidronate either as a one off treatment to reduce calcium levels in your blood. Or you may have it every 3 to 4 weeks as a regular treatment to prevent or reduce bone damage.
You have blood tests regularly during your treatment. The tests check your blood calcium levels. You may also need to do some urine samples for testing. You may also have tests to check how well your heart and kidneys are working.
More than 10 in every 100 people have one or more of these.
- Flu like symptoms, including a fever and chills and a headache, affect about 1 in 3 people (33%) for about 24 to 48 hours after the treatment
- Low levels of calcium in your blood (hypocalcaemia) – you will have blood tests to check the levels of calcium and other substances, such as potassium, phosphate, and magnesium. Usually, the blood test will pick up any imbalance before you have any symptoms. A low calcium level can cause changes in sensation so you may have tingling or burning in your lips and tongue. Let your doctor or nurse know if you have this
- Drowsiness or dizziness for a few hours after the treatment – it is important not to drive or operate machinery during this time
Between 1 and 10 in every 100 people have one or more of these.
- Feeling or being sick – you can usually control this with anti sickness medicines
- Stomach pain affects just under 1 in 10 people (9 to 10%)
- Joint or muscle pain
- Difficulty sleeping
- A skin rash
- Kidney changes – you will have regular blood tests to check how well your kidneys are working
- Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Red and sore eyes – your nurse will give you eye drops
- Loss of appetite
- Bone pain – you may have more bone pain when you first start treatment and may need stronger painkillers until it improves
- Anaemia (a drop in the number of red blood cells)
- Changes to the way your bowels work – you may be constipated or have diarrhoea
- Changes in blood pressure – during treatment, your blood pressure may be lower or higher than usual. Your nurse or doctor will check this regularly
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Redness and pain at the injection site
- Damage to the jaw bone (osteonecrosis) – this can be a side effect of taking bisphosphonates for longer than a year. Have a dental check up before you start treatment and tell your dentist that you are having pamidronate. You may need to stop having pamidronate if you need dental treatment. It is important to clean your teeth regularly and have regular dental checks
- Changes in your heart rhythm – you may have a test called an ECG to check this
Fewer than 1 in 100 people have these.
- Pain in several areas of the body
- Muscle cramps
- Mood changes – you may feel anxious or agitated while you are having this drug
- Fits (seizures) – let your doctor know straight away if you have this
- Blurred vision
- An allergic reaction to the drug, causing faintness, a sudden, itchy rash, swelling of the hands, feet, face, lips, eyelids, mouth or throat, and difficulty swallowing or breathing – let your doctor or nurse know straight away if you have this
The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment. Or you may develop more side effects as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Medicines that may react with pamidronate include
- Other medicines for high calcium levels
- Medicines that may affect the kidneys
- The drug thalidomide that is used to treat some cancers
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug. Talk to your doctor or nurse about effective contraception before starting treatment.
Do not breastfeed during this treatment because the drug may come through in the breast milk.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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