Pamidronate
- IVPamidronateArediaUsed to treat lytic lesions / hypercalcaemia of malignancy
Mechanism of Action
- Structural analogue of pyrophosphate that bind to the resorptive surface of osteoclasts and are internalised. Disruption of key regulatory proteins results in inhibition of osteoclastic function and reduction in bone resorption.
- Pharmacology
- Patients should remain upright for at least 20 minutes after taking oral bisphosphonates, in order to reduce risk of oesophagitis / gastritis.
- Often given in combination with calcium carbonate and cholecalciferol.
Clinical Use
- Indications
- Osteoporosis
- Paget's disease of bone
- Lytic lesions - breast cancer metastasis, multiple myeloma
- Hypercalcaemia of malignancy
- Contraindications
- Hypocalcaemia
- Delayed oesophageal emptying - stricture, achalasia
- Inability to stand / sit upright
- Adverse Effects
- Headache
- Oesophagitis / gastritis
- Nausea / vomiting / diarrhea
- Muscle / bone / joint pain
- Atypical femoral fractures
- Osteonecrosis of the jaw