Pamidronic acid

Overview
Pamidronic acid (INN) or pamidronate disodium (USAN), marketed as pamidronate disodium pentahydrate under the brand name Aredia®, is a bisphosphonate.

Uses
It is used to prevent bone loss, and treat osteoporosis. It is also used to strengthen bone in Paget's disease, to prevent bone loss due to steroid use, and in certain cancers with high propensity to bone, such as multiple myeloma. In multiple myeloma, it is usually administered as an intravenous infusion, lasting about 3 hours. The therapy is repeated monthly, and lasts for the life of the patient. Due to its ability to sequester calcium in bone, it is also used to treat high calcium levels.

Administration
Intravenous, usually 90 mg monthly. 30 mg, 60 mg, and 90 mg vials are available, mixed with mannitol.

Side effects
Common side effects include bone pain, low calcium levels, nausea, and dizziness. Osteonecrosis of the jaw is a rare complication which has been associated with the use of bisphosphonates, including pamidronate.

Pamidronate activates human γδ T cells in vitro and in vivo, which may lead to flu-like symptoms upon administration.