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pamidronate

( pam-ID-droe-nate )

Appearance: Clear solution mixed into larger volumes of fluids

pamidronate patient.pdf

pamidronate pour le patient.pdf

Medication Information Sheet

pamidronate (pam-ID-droe-nate)

This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Appearance:

Clear solution

mixed into larger volumes of fluids

What is this medication for?

To help relieve bone pain and prevent broken bones in some cancers
To treat too much calcium in the blood caused by certain types of cancer

What should I do before I have this medication?

Tell your health care team if you have or had significant medical condition(s), especially if you have / had:

kidney, heart, eye problems,
low calcium or vitamin D levels,
sores in your mouth,
any dental problems (including wearing dentures),
any planned dental work, or
any allergies

If you take other medications (such as calcitonin or other bisphosphonates) for bone problems, talk to your health care team before starting pamidronate.

Tell your dentist that you are on pamidronate.

Remember to:

Tell your health care team about all of the other medications you are taking.
Keep taking other medications that have been prescribed for you, unless you have been told not to by your health care team.

How will this medication affect sex, pregnancy and breastfeeding?

Talk to your health care team about:

How this medication may affect your sexual health.
How this medication may affect your ability to have a baby, if this applies to you.

This medication may harm an unborn baby. Tell your health care team if you or your partner are pregnant, become pregnant during treatment, or are breastfeeding.

If there is any chance of pregnancy happening, you and your partner together must use 2 effective forms of birth control at the same time until at least 6 months (general recommendation) after your last dose. Talk to your health care team about which birth control options are best for you.
Do not breastfeed while on this medication.

How is this medication given?

This drug is given through an IV (injected into a vein). Talk to your health care team about your treatment schedule.
- It is usually given at regular intervals in cancer involving the bones, with or without chemotherapy.
- To remove too much calcium in the blood, pamidronate is usually given for one course.
Your health care team may give you extra fluids, to ensure your kidneys can remove too much calcium properly from your body or prevent kidney problems.
To prevent lowering of your calcium level while using pamidronate, your health care team may tell you to take calcium and vitamin D supplements. Do not take calcium or vitamin D if you have / had high calcium levels in the blood. Talk to your health care team before taking these supplements.

What else do I need to know while on this medication?

Will this medication interact with other medications or natural health products?

This medication can interact with other medications, vitamins, foods and natural health products. Interactions can make the treatment not work as well or cause severe side effects.
Tell your health care team about all of your:
- prescription and over-the-counter (non-prescription) medications and all other drugs, such as cannabis/marijuana (medical or recreational)
- natural health products such as vitamins, herbal teas, homeopathic medicines, and other supplements
Check with your health care team before starting or stopping any of them.

What to DO while on this medication:

Rarely, some people may have jaw, teeth or mouth problems while using pamidronate.

DO look for teeth, mouth or jaw problems. You may have pain and swelling, poor healing of mouth sores, unusual discharge from gums, loosening of teeth, and the feeling of numbness or heaviness in the jaw.
DO contact your health care team as soon as possible if you get any of these symptoms.
DO check with your health care team before getting any dental procedures.
DO maintain good dental hygiene and have regular checkups with your dentist, to prevent jaw problems.

What NOT to DO while on this medication:

DO NOT drive, operate machinery or do any tasks that need you to be alert if you feel tired or sleepy.

What are the side effects of this medication?

The following table lists side effects that you may have when getting pamidronate. Some of the side effects may be related to chemotherapy as they were seen in patients given pamidronate while on chemotherapy.

The table is set up to list the most common side effects first and the least common last. It is unlikely that you will have all of the side effects listed and you may have some that are not listed.

Read over the side effect table so that you know what to look for and when to get help. Refer to this table if you experience any side effects while on pamidronate.

Common Side Effects (25 to 49 out of 100 people)
Headache, Flu-like symptoms You may feel like you have the flu for around 2 days after your pamidronate treatment. These flu-like symptoms may not be signs of an infection. What to look for? You may have chills, headache and muscle pain. You may feel tired and have a poor appetite. Symptoms may happen at any time after you receive your treatment and usually go away as your body gets used to the medication. What to do? Check your temperature to see if you have a fever. You have a fever if your temperature taken in your mouth (oral temperature) is: 38.3°C (100.9°F) or higher at any time OR 38.0°C (100.4°F) or higher for at least one hour. If you do have a fever, try to speak to your health care team. If you are unable to talk to them for advice, you MUST get emergency medical help right away.	Talk to your health care team if it does not improve or if it is severe.

Common Side Effects (25 to 49 out of 100 people)

Side effects and what to do

When to contact health care team

Headache, Flu-like symptoms

You may feel like you have the flu for around 2 days after your pamidronate treatment. These flu-like symptoms may not be signs of an infection.

What to look for?

You may have chills, headache and muscle pain.
You may feel tired and have a poor appetite.
Symptoms may happen at any time after you receive your treatment and usually go away as your body gets used to the medication.

What to do?

Check your temperature to see if you have a fever. You have a fever if your temperature taken in your mouth (oral temperature) is:
- 38.3°C (100.9°F) or higher at any time
  OR
- 38.0°C (100.4°F) or higher for at least one hour.
If you do have a fever, try to speak to your health care team. If you are unable to talk to them for advice, you MUST get emergency medical help right away.

Talk to your health care team if it does not improve or if it is severe.

Less Common Side Effects (10 to 24 out of 100 people)
Side effects and what to do	When to contact health care team
Mild joint, muscle pain or cramps What to look for? New pain in your muscles or joints, muscle cramps, or feeling achy. What to do? Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed. Talk to your health care team before you start taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or ASA (Aspirin®), as they may increase your chance of bleeding or interact with your cancer treatment. Rest often and try light exercise (such as walking) as it may help. Ask your health care team for the Pain pamphlet for more information.	Talk to your health care team if it does not improve or if it is severe.
Cough and feeling short of breath What to look for? You may have a cough and feel short of breath. Symptoms that commonly occur with a cough are: Wheezing or a whistling breathing Runny nose Sore throat Heartburn Weight loss Fever and chills Rarely this may be severe with chest pain, trouble breathing or coughing up blood. What to do? Check your temperature to see if you have a fever. If you have a fever, try to talk to your health care team. If you are not able to talk to them for advice, you MUST get emergency medical help right away. If you have a severe cough with chest pain, trouble breathing or you are coughing up blood, get medical help right away.	Talk to your health care team. If you are not able to talk to your health care team for advice, and you have a fever or severe symptoms, you MUST get emergency medical help right away.
Low Appetite What to look for? Loss of interest in food or not feeling hungry. Weight loss. What to do? Try to eat your favourite foods. Eat small meals throughout the day. You may need to take meal supplements to help keep your weight up. Talk to your health care team if you have no appetite. Ask your health care team for the Loss of Appetite pamphlet for more information.	Talk to your health care team if it does not improve or if it is severe.
Too much or too little salt in your body What to look for? Muscle spasms, cramping, weakness, twitching, or convulsions. Irregular heartbeat, confusion or blood pressure changes. What to do? Get emergency medical help right away for severe symptoms.	Get emergency medical help right away for severe symptoms.
Pains or cramps in the belly What to look for? Pain or cramps in your belly. Constipation and diarrhea can cause pain in your belly. What to do? If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.	Talk to your health care team if it does not improve or if it is severe.
Heartburn; upset stomach; bloating What to look for? Pain or burning in the middle or top part of your chest. It may get worse when you are lying down or bending over or when you swallow. A bitter or acidic taste in your mouth. What to do? Drink clear liquids and eat small meals. Do not eat acidic, fatty or spicy foods. Limit caffeine (like coffee, tea) and avoid alcohol. Avoid smoking or being around tobacco. Sit up or stand after eating. Do not lie down. Raise the head of your bed six to eight inches. You may need to use extra pillows to do this.	Talk to your health care team if it does not improve or if it is severe.

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

blurred vision or other changes to your vision
ear pain, discharge from the ear, ear infections that keep coming back
irregular heartbeat, chest pain, fainting or swelling of your legs
lower back pain, body swelling, peeing less than usual and having unusual weight gain
yellowish skin or eyes, unusually dark pee or pain on the right side of your belly
severe or unusual bone pain especially in your back, hips and wrist
signs of an allergy such as itchiness, rash, swollen lips, face or tongue, chest and throat tightness
seizure
bleeding from your gums, unusual nosebleeds, bruising easily or more than normal, or blood in your urine (pee) or stools (poo), bleeding that doesn't stop or is very heavy
feeling more tired, short of breath or weaker than normal, have pale skin, cold hands and feet

Who do I contact if I have questions or need help?

My cancer health care provider is: ______________________________________________

During the day I should contact:________________________________________________

Evenings, weekends and holidays:______________________________________________

Other Notes:

____________________________________________________________________________

December 2023 Updated information sheet

For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

pamidronate

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