Pamidronate Injection
Pamidronate Injection is an intravenous bisphosphonate used to treat high calcium levels caused by cancer, Paget's disease of bone, and bone damage from breast cancer or multiple myeloma.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 2 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Pamidronate Injection: Patient Information Guide
A plain-language walkthrough of Pamidronate Injection — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Pamidronate Disodium Injection is used for conditions where bones are breaking down too quickly — whether from cancer, a tumor's effect on calcium, or a bone disease.
- Hypercalcemia of malignancy: Treats moderate or severe high blood calcium caused by cancer (with or without bone involvement), given alongside IV fluids
- Paget's disease of bone: Treats moderate to severe Paget's disease, a condition where bones break down and regrow abnormally, often causing pain and deformity
- Osteolytic bone metastases of breast cancer: Used alongside standard cancer treatment to reduce bone damage when breast cancer has spread to the bones
- Osteolytic lesions of multiple myeloma: Used alongside standard cancer treatment to treat bone damage caused by multiple myeloma
⚙️How it works▾
Pamidronate belongs to a class of drugs called bisphosphonates. It attaches directly to calcium crystals (called hydroxyapatite) in bone, where it blocks osteoclasts — the cells responsible for breaking bone down. By slowing bone breakdown, pamidronate helps keep calcium from flooding into the bloodstream and helps reduce bone damage from tumors or disease.
In cancer patients, tumors can overstimulate osteoclast activity, causing bones to release calcium rapidly — which is what drives dangerously high blood calcium. Pamidronate directly counters this process. It is not broken down by the body; it is absorbed into bone and cleared by the kidneys.
💊How it's taken▾
Pamidronate Disodium Injection is always given intravenously (into a vein) by a healthcare professional — it cannot be taken by mouth. The infusion must run slowly, at least over 2 hours, to protect the kidneys; longer infusions are often used.
- For high blood calcium from cancer: typically given as a single infusion, with retreatment possible after at least 7 days if needed
- For Paget's disease: given once daily over 3 consecutive days
- For multiple myeloma bone lesions: given once a month
- For breast cancer bone metastases: given every 3 to 4 weeks
Always follow your care team's instructions. Kidney function is checked before each treatment, and treatment may be paused if kidneys are not working well enough.
🤒Side effects — in detail▾
The most commonly reported side effects with Pamidronate Disodium Injection include:
- Fever (mild temperature rise within 48 hours of infusion — very common)
- Nausea, vomiting, or abdominal pain
- Fatigue or weakness
- Bone pain or muscle aches
- Headache
- Redness, swelling, or pain at the IV insertion site
- Low blood levels of calcium, potassium, magnesium, or phosphate
- Constipation or loss of appetite
More serious reactions to watch for include signs of kidney problems (less urination, swelling), muscle cramps or spasms from low calcium, jaw pain or non-healing sores in the mouth, new thigh or groin pain, and eye redness or pain. Contact your care team right away if any of these occur.
⚠️Warnings & precautions▾
- Kidney damage: Pamidronate can cause serious kidney problems, including kidney failure. Kidney function is tested before each dose. Single doses must not exceed 90 mg, and infusions must never be given too quickly. People with severe kidney impairment should not use it for bone metastases.
- Osteonecrosis of the jaw (ONJ): Bone tissue death in the jaw has been reported, especially in cancer patients also on chemotherapy. A dental exam and any needed dental work should be completed before starting treatment. Avoid invasive dental procedures during treatment if possible.
- Atypical femur fractures: Unusual thigh bone fractures can occur with little or no injury. Report any new thigh or groin pain to your doctor promptly.
- Low blood calcium and electrolyte imbalances: Blood levels of calcium, magnesium, potassium, and phosphate must be monitored. Supplements may be needed.
- Fetal harm: Pamidronate can harm an unborn baby. Effective contraception is required during and after treatment. Do not breastfeed during or after treatment.
🔀What it interacts with▾
Pamidronate Disodium Injection can interact with certain drugs and IV solutions. Your care team should know about all medications you are taking.
- Nephrotoxic drugs (kidney-damaging medications): Using pamidronate with other drugs that can harm the kidneys raises the risk of serious kidney damage — use together with caution
- Thalidomide: In multiple myeloma patients, combining thalidomide with pamidronate increases the risk of kidney deterioration
- Calcium-containing IV fluids (e.g., Ringer's solution): Must never be mixed with pamidronate in the same IV line — causes a physical incompatibility
- Loop diuretics (e.g., furosemide): Do not appear to interfere with how pamidronate lowers calcium levels, but electrolyte balance should still be carefully monitored
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Allergy to bisphosphonates or mannitol: Pamidronate is contraindicated if you have had a serious allergic reaction (including anaphylaxis) to pamidronate, any other bisphosphonate, or mannitol
- Kidney problems: Tell your doctor about any kidney disease — the drug is cleared by the kidneys, and pamidronate is not recommended in severe kidney impairment for bone metastases
- Pregnancy: Pamidronate can harm a developing baby. A pregnancy test is recommended before starting. Use effective contraception during and after treatment, as the drug stays in bone for years
- Breastfeeding: Do not breastfeed during or after treatment — pamidronate may be released from bone into breast milk over time
- Dental health: Tell your dentist you are starting this medication. A dental exam should be done before treatment begins; invasive dental procedures should be avoided if possible during therapy
- Older adults: Use with extra care — older patients may have reduced kidney, liver, or heart function that affects how the drug is tolerated
- Children: Safety and effectiveness have not been established in pediatric patients; pamidronate is not approved for use in children
- Heart failure: Patients with heart failure must avoid overhydration during treatment — tell your care team about any heart conditions
🚑If you take too much▾
Taking too much pamidronate can cause dangerously low blood calcium, leading to muscle cramps, spasms, or numbness. Cases of accidental overdose have been reported, and all patients survived but required treatment with intravenous and/or oral calcium. High fever and low blood pressure have also been reported with very large doses.
Single doses must not exceed 90 mg. If an overdose is suspected, seek medical care immediately — treatment focuses on correcting the low calcium level.
📡Pharmacodynamics — effects in the body▾
After a pamidronate infusion, blood phosphate levels typically drop — because less phosphate is released from bone and more is cleared by the kidneys as calcium regulation hormones normalize. Urinary calcium and markers of bone breakdown (like hydroxyproline) also fall, usually within the first week after treatment, reflecting the drug's action of slowing bone resorption.
In patients with high blood calcium from cancer, these changes bring calcium levels closer to normal. Blood phosphate levels usually return toward normal within 7 to 10 days; short-term calcium supplementation may be needed if calcium falls too low.
🔬Pharmacokinetics — how your body processes it▾
Pamidronate is given intravenously and is not processed (metabolized) by the body — it stays in its original form. About half of each dose is rapidly taken up by bone; the rest is filtered out by the kidneys and excreted in the urine, mostly within 5 days. The elimination half-life (the time it takes for half the drug to leave the bloodstream) is about 28 hours, though pamidronate bound to bone is released much more slowly — over weeks to years.
In patients with reduced kidney function, the drug clears more slowly from the blood, but because it is given only monthly, significant buildup is not generally expected with mild to moderate kidney impairment. Patients with mild to moderate liver impairment show somewhat higher drug levels, but this difference is not considered clinically important at monthly dosing intervals.
📦How to store it▾
Store at 20 to 25°C (68 to 77°F) .
📄 Written from Pamidronate Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Pamidronate Injection
29 supplements and herbal products have documented interactions with Pamidronate Injection in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 3
- Moderate · 16
- Minor · 10
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Pamidronate Injection — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly is pamidronate being used for in my case? ▾
How is this medication given, and how long does each infusion take? ▾
What side effects should I expect after my infusion? ▾
Why does my doctor check my kidney function before every treatment? ▾
I've heard bisphosphonates can cause jaw problems. Should I be worried? ▾
Is it safe to get pregnant or breastfeed while on pamidronate? ▾
Is Pamidronate Injection available over the counter? ▾
When was Pamidronate Injection first available? ▾
Who makes Pamidronate Injection? ▾
💬 Answers drafted from Pamidronate Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Pamidronate Injection comes
Pamidronate Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Pamidronate Disodium Injection treats moderate or severe hypercalcemia of malignancy (high blood calcium due to cancer), used with adequate hydration
- Pamidronate Disodium Injection treats moderate to severe Paget's disease of bone
- Pamidronate Disodium Injection treats osteolytic bone metastases of breast cancer, used with standard cancer therapy
- Pamidronate Disodium Injection treats osteolytic lesions of multiple myeloma, used with standard cancer therapy
- Pamidronate Disodium Injection is given by slow intravenous infusion only — never as a rapid IV push — and must run for at least 2 hours to reduce kidney risk
- Pamidronate Disodium Injection must not be mixed with calcium-containing IV solutions such as Ringer's solution, and must be given in its own separate IV line
- Pamidronate Disodium Injection is given at different schedules depending on the condition: as a single infusion for high calcium from cancer, over 3 consecutive days for Paget's disease, monthly for multiple myeloma, or every 3 to 4 weeks for breast cancer bone metastases
- Patients with Paget's disease or bone metastases who are at risk for low calcium should take oral calcium and vitamin D supplements as directed by their doctor
📊 Pamidronate Injection across the U.S. market
How Pamidronate Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
📈 How widely Pamidronate Injection is used
A general measure of how commonly Pamidronate Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Pamidronate Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Pamidronate Injection prescribed? Of the 1,597 medications we measure, Pamidronate Injection ranks #1,486 by Medicaid prescriptions — more than 7% of them.
Utilization by Pamidronate Injection product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
10 ML pamidronate disodium 3 MG/ML Injection
Summed across the 2 of 3 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 1737449
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Pamidronate Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 2 of 3 listed Pamidronate Injection NDCs with Medicaid activity.
🔍 Compare Pamidronate Injection products
A representative set of FDA-listed product records for Pamidronate Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| 3 mg/mL | Intravenous | Areva Pharmaceuticals Inc. | ANDA | View NDC → |
| 6 mg/mL | Intravenous | Areva Pharmaceuticals Inc. | ANDA | View NDC → |
| 9 mg/mL | Intravenous | Areva Pharmaceuticals Inc. | ANDA | View NDC → |
| 3 mg/mL | Intravenous | Hospira, Inc. × 3 listings | ANDA | View NDC → |
| 6 mg/mL | Intravenous | Hospira, Inc. × 3 listings | ANDA | View NDC → |
| 9 mg/mL | Intravenous | Hospira, Inc. × 3 listings | ANDA | View NDC → |
| 3 mg/mL | Intravenous | Mylan Institutional LLC × 3 listings | ANDA | View NDC → |
| 9 mg/mL | Intravenous | Mylan Institutional LLC × 3 listings | ANDA | View NDC → |
Showing 18 of 18 products — FDA National Drug Code Directory. See every product, package size and price: browse all 18 Pamidronate Injection NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Pamidronate Injection — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Pamidronate Injection in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Pamidronate Injection went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 11473 1 dose form · 5 strengths
-
Dose form (SCDF) Injection RxCUI 1737448In current FDA listingsClinical drug / strength (SCD) disodium 30 MGRxCUI 1737459disodium 90 MGRxCUI 173746110 ML pamidronate disodium 3 MG/MLRxCUI 173744910 ML pamidronate disodium 6 MG/MLRxCUI 173745110 ML pamidronate disodium 9 MG/MLRxCUI 1737453
Look up RxCUI 11473 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Pamidronate Injection is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Pamidronate Injection belongs to the Bisphosphonate class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 2 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Mylan Institutional LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.