Disodium pamidronate (Aredia)

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

• Myeloma
• Secondary breast cancer
• Secondary prostate cancer

You may also have pamidronate to treat high levels of calcium in the blood (hypercalcaemia) caused by secondary cancer of the bone.

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 for up to 90 minutes.

You may have pamidronate either as a one off treatment to reduce calcium levels in your blood, or every 3 to 4 weeks as a regular treatment to prevent or reduce bone damage.

We have listed the possible side effects below. There is general information about bisphosphonates in the cancer treatment section of CancerHelp UK.

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%)
• 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
• Pamidronate may have a harmful effect on a developing baby and you should not become pregnant or father a child whilst taking this drug. Discuss contraception with your doctor or nurse before you start your treatment if there is any possibility that you or your partner could become pregnant
• Drowsiness or dizziness for a few hours after the treatment – it is important not to drive or operate machinery during this time
• Feeling or being sick – you can usually control this with anti sickness medicines

Between 1 and 10 in every 100 people have one or more of these.

• Stomach pain affects just under 1 in 10 people (9 to 10%)
• Difficulty sleeping
• Mood changes – you may feel anxious or agitated while you are having this drug
• A skin rash
• 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
• Redness and pain at the injection site

Fewer than 1 in 100 people have these.

• Kidney problems – your doctor will take blood tests to check how well your kidneys are working
• Osteonecrosis of the jaw – 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

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

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.