What is this medication?

PAMIDRONATE (pa mi DROE nate) slows calcium loss from bones. It treats Paget's disease and high calcium levels in the blood from some kinds of cancer. It may be used in other people at risk for bone loss.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Aredia

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• bleeding disorder
• cancer
• dental disease
• kidney disease
• low levels of calcium or other minerals in the blood
• low red blood cell counts
• receiving steroids like dexamethasone or prednisone
• an unusual or allergic reaction to pamidronate, other drugs, foods, dyes or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

This drug is injected into a vein. It is given by a health care provider in a hospital or clinic setting.

Talk to your health care provider about the use of this drug in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your health care provider if you are unable to keep an appointment.

What may interact with this medication?

• certain antibiotics given by injection
• medicines for inflammation or pain like ibuprofen, naproxen
• some diuretics like bumetanide, furosemide
• cyclosporine
• parathyroid hormone
• tacrolimus
• teriparatide
• thalidomide

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your health care provider for regular checks on your progress. It may be some time before you see the benefit from this drug.

Some people who take this drug have severe bone, joint, or muscle pain. This drug may also increase your risk for jaw problems or a broken thigh bone. Tell your health care provider right away if you have severe pain in your jaw, bones, joints, or muscles. Tell you health care provider if you have any pain that does not go away or that gets worse.

Tell your dentist and dental surgeon that you are taking this drug. You should not have major dental surgery while on this drug. See your dentist to have a dental exam and fix any dental problems before starting this drug. Take good care of your teeth while on this drug. Make sure you see your dentist for regular follow-up appointments.

You should make sure you get enough calcium and vitamin D while you are taking this drug. Discuss the foods you eat and the vitamins you take with your health care provider.

You may need blood work done while you are taking this drug.

Do not become pregnant while taking this drug. Women should inform their health care provider if they wish to become pregnant or think they might be pregnant. There is potential for serious harm to an unborn child. Talk to your health care provider for more information.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care provider as soon as possible:

• allergic reactions (skin rash, itching or hives; swelling of the face, lips, or tongue)
• bleeding (bloody or black, tarry stools; red or dark brown urine; spitting up blood or brown material that looks like coffee grounds; red spots on the skin; unusual bruising or bleeding from the eyes, gums, or nose)
• bone pain
• increased thirst
• infection (fever, chills, cough, sore throat, pain or trouble passing urine)
• jaw pain, especially after dental work
• joint pain
• kidney injury (trouble passing urine or change in the amount of urine)
• low calcium levels (fast heartbeat; muscle cramps or pain; pain, tingling, or numbness in the hands or feet; seizures)
• low magnesium levels (fast, irregular heartbeat; muscle cramp or pain; muscle weakness; tremors; seizures)
• low potassium levels (trouble breathing; chest pain; dizziness; fast, irregular heartbeat; feeling faint or lightheaded, falls; muscle cramps or pain)
• muscle pain
• pain, redness, or irritation at site where injected
• redness, blistering, peeling, or loosening of the skin, including inside the mouth
• severe diarrhea
• unusual sweating

Side effects that usually do not require medical attention (report to your doctor or health care provider if they continue or are bothersome):

• constipation
• eye irritation, itching, or pain
• fever
• headache
• increase in blood pressure
• loss of appetite
• nausea
• stomach pain
• unusually weak or tired
• vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This drug is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.