Indication: Hypercalcemia in Malignancy
- Pamidronate disodium injection is indicated for the treatment of moderate or severe hypercalcemia associated with malignancy, with or without bone metastases
- Vigorous saline hydration, should be initiated promptly along with pamidronate therapy
- if possible the urine output should be about 2 L/day throughout treatment
- Patients who receive pamidronate disodium injection should have serum creatinine assessed prior to each treatment
- Treatment should be withheld for renal deterioration
- recommended dose of pamidronate disodium injection in severe hypercalcemia (corrected serum calcium* >13.5 mg/dL) is 90 mg given as a single-dose, intravenous infusion over 2 to 24 hours.
- Longer infusions (i.e., greater than 2 hours) may reduce the risk for renal toxicity, particularly in patients with preexisting renal insufficiency/impairment.
- *Albumin-corrected serum calcium = serum calcium, mg/dL + 0.8 (4-serum albumin, g/dL).
Retreatment
- Retreatment with pamidronate disodium injection in patients who show complete or partial response initially may be carried out if serum calcium does not return to normal or remain normal after initial treatment.
- A minimum of 7 days between treatments is recommended to allow for full response to the initial dose
Indication: Osteolytic Bone Metastases of Breast Cancer
- Pamidronate disodium injection is indicated in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma
- Recommended dose of pamidronate disodium injection in patients with osteolytic bone metastases is 90 mg administered over a 2-hour infusion given every 3 to 4 weeks
- The optimal duration of therapy is not known; however, in two breast cancer studies, final analyses performed after 24 months of therapy demonstrated overall benefits
References:
- http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020036s035lbl.pdf
- http://www.drugs.com/pro/pamidronate-intravenous-infusion.html
Pamidronate belongs to the family of medications known as bisphosphonates. It is used to treat hypercalcemia (high blood calcium) by people who have cancer. Pamidronate is also used to treat cancer that has spread to bones (bone metastases) due to different types of tumours and multiple myeloma (cancer of the bone marrow). Pamidronate is also used to treat the symptoms of Paget's disease of bone.
ReplyDeleteThis medication works by reducing the breakdown of bone.
For hypercalcemia due to cancer (high calcium levels in the blood), the recommended total dose of pamidronate per treatment course will depend on the starting levels of calcium in the blood. The recommended maximum dose per treatment course is 90 mg, which can be given as a single intravenous (into the vein) infusion of 90 mg or multiple infusions spread over 2 to 4 days.
For bone metastases and multiple myeloma, the recommended dose of pamidronate is 90 mg given as a single-dose intravenous infusion every 4 weeks. The dose should be given over a period of 2 to 4 hours. People who receive chemotherapy every 3 weeks may receive 90 mg of pamidronate every 3 weeks.
For Paget's disease of bone, the recommended dose of pamidronate ranges from 180 mg to 210 mg given as intravenous infusions. The initial dosing schedule may be either 6 doses of 30 mg once a week (total dose 180 mg), or 30 mg for the first dose and 3 doses of 60 mg every second week (total dose 210 mg). Once this dosing schedule is complete, it can be repeated after 6 months. For repeat dosing, pamidronate is usually given as 3 doses of 60 mg every second week (total dose 180 mg).
Source: Dependable Canadian Pharmacy
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