Pamidronate Pharmacology

Pamidronate

About Pamidronate
Nitrogenous Bisphosphanate Derivative, Bone resorption inhibitor, antihypercalcemic.
Mechanism of Action of Pamidronate
Pamidronate is a second generation aminobisphosphonate. It is an analogue of pyrophosphate in which the P-O-P bond is replaced by a non hydrolysable P-C-P bond. With divalent cation such as Ca2+ (calcium ion) in the bone they can capable to form chelating complex and form a three dimensional structure. Pamidronate has high affinity for active remodeling site in the bone. Bisphosphonate retard formation and dissolution of hydroxy apatite crystals within bone and other site. Bisphosphonates remain in the matrix until the bone is remolded and then released in the acid environment of the resorption lacunae beneath the osteoclast as the overlying mineral matrix is dissolved. It produces antiresorptive action by osteoclast apoptosis activity and by inhibition of components of the cholesterol biosynthetic pathway. This is 10 - 100 times more potent than 1st generation compounds.
Pharmacokinets of Pamidronate
Absorption: It is rapidly and completely absorbed after intravenous administration.
Distribution: About 50 - 60 % is mainly concentrated in bone and remains seen in kidney, liver, spleen, teeth and tracheal cartilage
Metabolism: none
Excretion: Excreted mainly in the urine.

Onset of Action for Pamidronate
Rapid
Duration of Action for Pamidronate
Up to 6 months
Half Life of Pamidronate
N/A
Side Effects of Pamidronate
1. Fever
2. Pain at infusion site
3. Abdominal pain
4. Nausea
5. Vomiting
6. Anorexia
7. Constipation
8. Gastrointestinal haemorrhage
9. Generalised pain
10. Hypophosphataemia
11. Hypokalaemia
12. Hypocalcaemia
13. Hypomagnesaemia
14. Bone pain
15. Hypertension
16. Leukopenia
Contra-indications of Pamidronate
1. Hypersensitivity to Pamidronate and other biphosphonates
Special Precautions while taking Pamidronate
1. Renal impairment
2. Monitor serum levels of calcium, phosphate, magnesium and potassium levels
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
NEONATES : Contraindicated
Indications for Pamidronate
1. Hypercalcaemia associated with malignancy
2. Paget`s disease
3. Osteolytic bone lesions of multiple myeloma
4. Osteoporosis
Interactions for Pamidronate
Concomitant administration of a loop diuretic has no effect on the calcium lowering action of pamidronate.
Typical Dosage for Pamidronate
Intravenous infusion:
Adult:
30 - 90mg over 4 - 12 hours once/ day to once in 2 months depending on the condition
Hypercalcaemia: Dose is depending on the severity and symptoms of Hypercalcaemia.
Moderate Hypercalcaemia (corrected serum calcium level is 12 - 13.5 mg / dl): 60 - 90 mg over 2 - 24 hour
Severe Hypercalcaemia (corrected serum calcium level more than 13.5 mg / dl): 90 mg over 2 - 24 hour
Paget`s disease: 30mg over 4 hours for 3 consecutive days, total dose 90 mg
Osteolytic bone lesions of multiple myeloma: 90mg over 4 hours/ month
Osteoporosis: 30mg intravenous infusion over 3 hour every 3 months
Oral:
Post menopausal Osteoporosis:150 to 300mg daily
Children: Not recommended

Schedule of Pamidronate
N/A
Storage Requirements for Pamidronate
Store at room temperature. The reconstituted solution should be stored at 2 - 8 degree C. The infusion solution is stable for up to 24 hours at room temperature.
Effects of Missed Dosage of Pamidronate
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Pamidronate
Give supportive measures and symptomatic treatment.

Home Delivery for Pamidronate in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including pamidronate.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for pamidronate and other medicines and health products. Home delivery services for pamidronate may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take pamidronate only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for pamidronate before they complete the sale. You can get this information while placing the order for pamidronate with the pharmacy.

Pamidronate is a generic medicine name and there are several brands available for it. Some of the brands for pamidronate might be better known than pamidronate itself. If the pharmacy that's willing to deliver medicines to your home doesn't have pamidronate in stock, you can ask for one of the branded alternatives for pamidronate.