Pamidronic acid

Pamidronic acid or pamidronate disodium (marketed as Aredia among others), is a nitrogen-containing bisphosphonate used to prevent osteoporosis.

Pamidronic acid
Clinical data
Trade namesAredia, Pamimed, among others
Other namesPamidronate disodium pentahydrate, pamidronate disodium
AHFS/Drugs.comInternational Drug Names
MedlinePlusa601163
Pregnancy
category
  • AU: B3
  • US: D (Evidence of risk)
    Routes of
    administration    		Intravenous
    ATC code
    Legal status
    Legal status
    Pharmacokinetic data
    Bioavailabilityn/a
    Protein binding54%
    MetabolismNil
    Elimination half-life28 ± 7 hours
    ExcretionRenal
    Identifiers
    CAS Number
    PubChem CID
    IUPHAR/BPS
    DrugBank
    ChemSpider
    UNII
    KEGG
    ChEMBL
    CompTox Dashboard (EPA)
    ECHA InfoCard100.049.897
    Chemical and physical data
    FormulaC3H11NO7P2
    Molar mass235.07 g/mol g·mol−1
    3D model (JSmol)
      (verify)

    It was patented in 1971 and approved for medical use in 1987.[1]

    Medical 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. 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 osteogenesis imperfecta. It has been studied in the treatment of complex regional pain syndrome.[2]

    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.[3]

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

    Pharmacology
    Relative potency[4]
    Bisphosphonate Relative potency
    Etidronate 1
    Tiludronate 10
    Pamidronate 100
    Alendronate 100-500
    Ibandronate 500-1000
    Risedronate 1000
    Zoledronate 5000

    References
    1. Fischer, Jnos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 523. ISBN 9783527607495.
    2. I. Kubalek; O. Fain; J. Paries; A. Kettaneh; M. Thomas (2001). "Treatment of reflex sympathetic dystrophy with pamidronate: 29 cases". Rheumatology. 40 (12): 1394–1397. doi:10.1093/rheumatology/40.12.1394. PMID 11752511.
    3. Zarychanski R, Elphee E, Walton P, Johnston J (2006). "Osteonecrosis of the jaw associated with pamidronate therapy". Am J Hematol. 81 (1): 73–5. doi:10.1002/ajh.20481. PMID 16369966.
    4. D., Tripathi, K. (2013-09-30). Essentials of medical pharmacology (Seventh ed.). New Delhi. ISBN 9789350259375. OCLC 868299888.


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