Pamidronic acid

Pamidronic acid

File:Pamidronic acid.svg
Systematic (IUPAC) name
(3-amino-1-hydroxypropane-1,1-diyl)bis(phosphonic acid)
Clinical data
AHFS/Drugs.com	International Drug Names
MedlinePlus	a601163
Pregnancy category	AU: B3 US: D (Evidence of risk)
Legal status	UK: POM (Prescription only) US: ℞-only
Routes of administration	Intravenous
Pharmacokinetic data
Bioavailability	n/a
Protein binding	54%
Metabolism	Nil
Biological half-life	28 ± 7 hours
Excretion	Renal
Identifiers
CAS Number	40391-99-9 Y
ATC code	M05BA03 (WHO)
PubChem	CID: 4674
IUPHAR/BPS	7259
DrugBank	DB00282 Y
ChemSpider	4512 Y
UNII	OYY3447OMC Y
KEGG	D07281 Y
ChEMBL	CHEMBL834 Y
Chemical data
Formula	C3H11NO7P2
Molecular mass	235.07 g/mol
SMILES O=P(O)(O)C(O)(CCN)P(=O)(O)O
InChI InChI=1S/C3H11NO7P2/c4-2-1-3(5,12(6,7)8)13(9,10)11/h5H,1-2,4H2,(H2,6,7,8)(H2,9,10,11) Y Key:WRUUGTRCQOWXEG-UHFFFAOYSA-N Y
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Pamidronic acid (INN) or pamidronate disodium (USAN), pamidronate disodium pentahydrate is a nitrogen-containing bisphosphonate, used to prevent osteoporosis. It is marketed by Novartis under the brand name Aredia. In India, it is marketed by Curacell Biotech under the brand name Pamimed.

Uses

It is used to prevent bone loss, and treat osteoporosis. It is also used to strengthen bone in Paget's disease, to prevent bone loss due to steroid use, and in certain cancers with high propensity to bone, such as multiple myeloma. In multiple myeloma, it is usually administered as an intravenous infusion, lasting about 3 hours. The therapy is repeated monthly, and lasts for the life of the patient. Due to its ability to sequester calcium in bone, it is also used to treat high calcium levels. It is also used as an experimental treatment of the bone disorder known as Osteogenesis Imperfecta. It has been studied in the treatment of Complex Regional Pain Syndrome.

Administration

Intravenous, usually 90 mg monthly. 30 mg, 60 mg, 90 mg and for hospitals, 120 mg vials are available, mixed with mannitol.

Side effects

Common side effects include bone pain, low calcium levels, nausea, and dizziness. Osteonecrosis of the jaw is a rare complication which has been associated with the use of bisphosphonates, including pamidronate.

Pamidronate activates human γδ T cells in vitro and in vivo, which may lead to flu-like symptoms upon administration.