Before Receiving This Medicine

In deciding to use a medicine, the risks of receiving the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pamidronate, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to pamidronate or other bisphosphonates such as alendronate, clodronate, etidronate, risedronate, tiludronate, or zoledronic acid. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in humans. However, studies in rats given higher doses of oral pamidronate have shown that the medicine may decrease fertility, increase the length of pregnancy, and cause death of the baby rat. You should avoid becoming pregnant while taking this medicine. If you do become pregnant tell your healthcare professional as soon as you can.

Breast-feeding—It is not known if pamidronate passes into breast milk.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of pamidronate in children with use in other age groups.

Older adults—When pamidronate is given along with a large amount of fluids, older people tend to retain (keep) the excess fluid.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving pamidronate, it is especially important that your health care professional know if you are taking any of the following:

• Calcium-containing preparations or
• Vitamin D-containing preparations—Use with pamidronate may keep pamidronate from working properly

• Anti-infectives by mouth or by injection (medicine for infection) or
• Carmustine (e.g., BiCNU) or
• Cisplatin (e.g., Platinol) or
• Combination pain medicine containing acetaminophen and aspirin (e.g., Excedrin) or other salicylates (with large amounts taken regularly) or
• Cyclosporine (e.g., Sandimmune) or
• Deferoxamine (e.g., Desferal) (with long-term use) or
• Gold salts (medicine for arthritis) or
• Inflammation or pain medicine except narcotics or
• Lithium (e.g., Lithane) or
• Methotrexate (e.g., Rheumatrex, Trexall) or
• Penicillamine (e.g., Cuprimine) or
• Plicamycin (e.g., Mithracin) or
• Tiopronin (e.g., Thiola)—Increased risk of harmful effects on the kidney

Other medical problems—The presence of other medical problems may affect the use of pamidronate. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood problems, such as
• Anemia
• Leukopenia
• Thrombocytopenia
  Your healthcare professional will watch your progress closely for two weeks after treatment

• Heart problems—The increased amount of fluid may make this condition worse

• Kidney problems—Pamidronate may build up in the bloodstream, which may increase the chance of unwanted effects