Pamidronate adverse effects

Pamidronate, 60-90 mg, infused over 2-4 hours, and zole-dronate, 4 mg, infused over at least 15 minutes, have been approved for the treatment of hypercalcemia of malignancy and have largely replaced the less effective etidronate for this indication. The effects generally persist for weeks, but treatment can be repeated after a 7-day interval if necessary and if renal function is not impaired. Some patients experience a self-limited flu-like syndrome after the infusion. Repeated doses of these drugs have been linked to renal deterioration and osteonecrosis of the jaw, but this adverse effect is rare. 

In 32 women treated for postmenopausal osteoporosis for 2 years with either pamidronate or with oral fluoride, adverse effects were a transient fever with influ-enza-like symptoms in five patients after the first infusion of pamidronate, and rigors and mild phlebitis in one patient (16). 

Adverse effects with various forms of pamidronate included 23 cases of suspected ocular adverse drug reactions associated with the use of intravenous pamidronate disodium (21). Bilateral anterior uveitis occurred 24-48 hours after administration in six cases three reports involved unilateral episcleritis, occurring 1-6 days after administration and 13 patients complained of non-specific transient conjunctivitis 6-8 hours after administration. 

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