# Pamidronate

Source: https://onco.cc/drugs/pamidronate/  
OnCo record `pamidronate` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pamidronate (Aredia) is a bisphosphonate infusion approved in 1991 for dangerously high blood calcium in cancer and later for bone damage from myeloma and breast cancer, where it roughly halved skeletal complications. Its two-hour infusion, against fifteen minutes for zoledronic acid, pushed most centres to switch, though it is cheaper and may cause less jaw osteonecrosis.

## Summary

Pamidronate disodium was approved in October 1991 for moderate or severe hypercalcaemia of malignancy with or without bone metastases and later for osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma in conjunction with standard antineoplastic therapy, on placebo-controlled trials (Hortobagyi 1996, Berenson 1996) that roughly halved skeletal complications. The two-hour infusion, compared with fifteen minutes for zoledronic acid, and the pivotal head-to-head hypercalcaemia trials led most centres to switch, although pamidronate remains a lower-cost generic option and is preferred by some in myeloma because of a lower rate of osteonecrosis of the jaw in observational series. Renal toxicity with rapid infusion, acute-phase reactions and jaw osteonecrosis are the key risks.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Tags: nci-list; generic; supportive
- Brand: Aredia (historic)
- Modality: Nitrogen-containing bisphosphonate (intravenous)
- Mechanism: Adsorbs to hydroxyapatite and inhibits osteoclast-mediated bone resorption, lowering serum calcium and reducing osteolytic lesion progression.
- Approvals: US 1991: Hypercalcaemia of malignancy; US 1995: Osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma, with antineoplastic therapy

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Pamidronic_acid
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=pamidronate
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/pamidronatedisodium

## Connected records

- drugs: [Denosumab](https://onco.cc/drugs/denosumab/), [Zoledronic acid](https://onco.cc/drugs/zoledronic-acid/)
- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/)
- technologies: [Bone-modifying agents (bisphosphonates, denosumab)](https://onco.cc/technologies/bone-modifying-agents/)
- companies: [Novartis](https://onco.cc/companies/novartis/)
- trials: [Combination Bisphosphonate and Anti-Angiogenesis Therapy With Pamidronate and Thalidomide](https://onco.cc/trials/nct00083382/), [Dexamethasone With or Without Thalidomide in Treating Patients With Newly Diagnosed Multiple Myeloma](https://onco.cc/trials/nct00033332/), [Pamidronate Prophylaxis in Multiple Myeloma 30 mg/Month Versus 90 mg/Month](https://onco.cc/trials/nct00376883/)

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