Drug & supplement interaction

Iron + Pamidronate

Pamidronate brand name: Aredia.

Moderate Interaction
The bottom line Moderate

Iron has a moderate interaction with Pamidronate. Iron reduces the absorption of bisphosphonates.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Iron and Pamidronate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

BISPHOSPHONATES

Why this applies to Pamidronate

Pamidronate falls under BISPHOSPHONATES — the group Iron interacts with.

Iron reduces the absorption of bisphosphonates.
Advise patients that doses of bisphosphonates should be separated by at least two hours from doses of all other medications, including supplements such as iron. Divalent cations, including iron, can decrease absorption of bisphosphonates by forming insoluble complexes in the gastrointestinal tract.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's some reassuring news for this particular pairing. Pamidronate (Aredia) is given as an intravenous infusion, straight into your vein at the clinic or hospital. The concern with iron and bisphosphonates is that iron can bind to the drug in your stomach and gut, forming clumps that don't absorb well. But since pamidronate skips the digestive tract entirely, your iron supplement won't get in the way of how well it works.

So in this specific case, the usual advice to space oral bisphosphonates two hours away from iron really applies to pill forms like alendronate, not the IV form you're getting. This is a theoretical, absorption-based concern, so I wouldn't lose sleep over it. Still, it's always smart to let your oncology team or pharmacist know about your iron supplement.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Iron Also Interacts With Other Medications

Iron has 78 moderate, 1 minor known drug interactions in our database — the Pamidronate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Iron

Covers the 2,830 medications we’ve checked against Iron. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pamidronate

This page covers Iron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pamidronate page lists 29 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Siberian Cocklebur (major), Aristolochia (moderate) and Calcium (moderate).

By severity: 3 major · 16 moderate · 10 minor.

From our pharmacist’s overview on the Pamidronate page

“If you receive pamidronate (Aredia) infusions for high calcium from cancer or for Paget's disease, the supplements that worry me most are the kidney-toxic ones. Pamidronate can already stress the kidneys on its own, and six herbs on this list of 29, Siberian cocklebur chief among them, can pile extra kidney damage on top of that.”

Reviewed by 2 · Jul 18, 2026

Open the Pamidronate interaction page

One more smart check

Taking Iron as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,325 real supplement products containing Iron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Iron. Your product may carry other ingredients that interact with Pamidronate too, on top of Iron — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Iron and Pamidronate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Iron
Top 1%

#14 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pamidronate
Steady interest

#2,578 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Iron

What is Iron?

  • Iron-deficiency anemia
  • Low iron stores during pregnancy
  • Fatigue from iron deficiency
  • Heavy menstrual blood loss
  • Restless legs syndrome (with low iron)

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency anemia, ideally after a blood test confirms you are low. Because too much iron can be harmful, take it only when needed and under the guidance of a pharmacist or doctor.

Read the full Iron monograph & all interactions
Medication

About Pamidronate Injection

What Is Pamidronate Injection Used For?

Brand name: Aredia

Pamidronate Disodium Injection is used to treat hypercalcemia of malignancy (dangerously high blood calcium caused by cancer), given alongside adequate fluid hydration. It is also approved for moderate to severe Paget's disease of bone, a condition where bones break down and rebuild abnormally.

In addition, Pamidronate Disodium Injection is used together with standard cancer treatment for osteolytic bone metastases of breast cancer (bone damage caused by breast cancer spreading to bone) and for osteolytic lesions of multiple myeloma (bone damage from this blood cancer).

See full Pamidronate Injection drug information
Keep checking

Other Drugs & Iron

Browse every other medication we’ve checked against Iron — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
78Moderate
1Minor
2,750No known interaction
Moderate

78 interactions

Showing 60 of 78 moderate interactions — see all 78 on the Iron page.

Minor

1 interaction

No interaction 2,750 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Iron and Pamidronate Together: Common Questions

Can you take Iron with Pamidronate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Iron and Pamidronate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.