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Precautions and Warnings With Pamidronate

There are many important precautions and warnings with pamidronate to be aware of before starting the drug, including information on who should not take it. You should not take pamidronate if you are pregnant or allergic to any components of the medicine. Prior to beginning treatment, make sure to let your healthcare provider know if you have kidney disease, low blood calcium, or any allergies.

Pamidronate: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking pamidronate disodium (Aredia®) if you have:
 
  • Kidney disease, including kidney failure (renal failure)
  • Low blood calcium (hypocalcemia)
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding
  • Planning to have a dental procedure.
     
Make sure to tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions for Pamidronate

Warnings and precautions to be aware of prior to taking pamidronate include the following:
 
  • Pamidronate can cause kidney damage. In order to decrease this risk, your pamidronate dose should be given by IV over at least a two-hour period and should not exceed 90 mg per dose. Your healthcare provider should monitor your kidney function closely, using a simple blood test. If your kidney function is declining, you may need to postpone your dose until your kidney function improves. If you already have kidney disease, pamidronate may not be a good choice for you.
     
  • In rare cases, bisphosphonates (such as pamidronate) have caused a condition called osteonecrosis of the jaw. This is a serious, possibly disfiguring problem in which the bone of the jaw dies. Often, there are symptoms (such as pain, infection, or loosening of the teeth), but sometimes there are no symptoms until a person notices exposed bone. This problem is most common when bisphosphonates are given by IV. It seems that people who have dental procedures (such as a tooth extraction) are also at higher risk. Be sure to take good care of your mouth and teeth by seeing your dentist frequently. Let your healthcare provider know right away if you think you may have osteonecrosis of the jaw.
     
  • Pamidronate can cause low blood calcium, phosphate, and magnesium. Your healthcare provider should monitor you closely for these problems.
     
  • Bisphosphonates (including pamidronate) can cause extreme muscle or bone pain. This usually goes away once the medication is stopped.
     
  • Pamidronate can potentially interact with a few other medications (see Drug Interactions With Pamidronate).
     
  • Pamidronate is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy (see Aredia and Pregnancy).
     
  • It is not known whether pamidronate passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Aredia and Breastfeeding).
     
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Pamidronate Disodium -- Drug Information

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