Pamidronic acid Pamidronate sodium

C3H7NO2 107-95-9) see Balsalazide sodium Calcium pantothenate Pamidronic acid L-alanine benzyl ester... 

Bisphosphonates alendronate sodium clodronate disodium etidronate disodium pamidronate disodium risedronate sodium zoledronic acid... 

For a batch size of 5 L, 587.5 g (3.2 moles) of mannitol is dissolved in 3.5 L of water. Pamidronic acid (31.6 g, 0.133 moles) is mixed with a 1.0 L aliquot of the mannitol solution to form a slurry. The slurry is then transferred into the remainder of the mannitol solution, and stirred for at least 15 min. Aqueous 1 N sodium hydroxide (270 ml) is then added and the mixture is stirred until a clear, colorless solution results. The pH is then adjusted to 6.50.1 using either 1 M aqueous phosphoric acid or 1 N aqueous sodium hydroxide, as needed. The solution is then filtered through a 0.22 micron filter, and filled at 20°C into vials at 4.0 ml (4.172 g)/vial, under sterile conditions. The aqueous solution is frozen at -37°C and lyophilized (20 mbar, 20°-40°C) to yield 1,250 vials, each containing 30 mg of amorphous disodium pamidronate. The vials are sealed under positive nitrogen pressure. The disodium pamidronate is amorphous (noncrystalline) by X-ray diffraction and contains 0.7 wt-% water. 

The treatment of Mrs CR s hypercalcaemia is urgent and requires immediate administration of bisphosphonate therapy, the first choice therapy in cases of severe hypercalcaemia. Currently four bisphosphonates are available in the UK for the treatment of malignant hypercalcaemia - sodium clodronate, disodium pamidronate, zoledronic acid and ibandronic acid. The choice of which bisphosphonate to recommend will depend on which one is on the local hospital formulary. 

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