Warning: Aredia and other bisphosphonates have been associated with renal toxicity. This was manifested as deterioration of renal function and possible renal failure. Single doses of this medication should not exceed 90 mg because of the risk of clinically significant deterioration in renal function that could lead to renal failure. This medication may cause fetal harm when given to pregnant women. Women of childbearing potential should be advised to avoid becoming pregnant.
Indications: Aredia, pamidronate disodium (APD), is a bone-resorption inhibitor. It is administered intravenously and comes in vials of 30-mg or 90-mg. It is used to treat high blood calcium and certain bone problems associated with some types of cancer. It can also be used to treat Paget’s disease that causes weak and abnormal bones.
In conjunction with adequate hydration it is indicated for the treatment of moderate to severe hypercalcemia associated with malignancy.
This can be with or without bone metastases. Patients who have non-epidermoid or epidermoid tumors have responded to treatment with this medication. An integral part of hypercalcemia therapy is its use of vigorous saline hydration. Throughout the treatment patients should be hydrated adequately, but caution should be taken not to over hydrate. Over hydration could be an issue for patients who have cardiac failure.
In regards to Paget’s disease, this drug has been effective in reducing biochemical markers in the patients with this disease. It is used when Paget’s disease has failed to or no longer responds to other treatments.
Dosage: Severity as well as symptoms of hypercalcemia should be given consideration. If treating mild, asymptomatic hypercalcemia a vigorous saline hydration may be sufficient. Special consideration should be given to patients with cardiac failure to not over hydrate.
The recommended use for moderate hypercalcemia is 60 to 90 mg given in a single dose intravenously infused over 2 to 24 hours. If a patient has preexisting renal insufficiency, a longer infusion may reduce the risk for renal toxicity.
For severe hypercalcemia it is recommended that 90 mg of this drug is given in a single dose through intravenous infusion over 2 to 24 hours. If there is preexisting renal insufficiency a longer infusion may reduce the risk for renal toxicity.
Overdose: although almost non-existent, overdose of aredia can occur. If that happens, contact your doctor or emergency room immediately; they will make an intravenous infusion of calcium in your body to eliminate or reduce symptoms. Symptoms of Aredia overdose include:
- fever
- hypotension
- change in taste.
Missing dose: if you missed a dose of Aredia, talk to your doctor to know what you should do. Your doctor may advise you to take or completely skip the missed dose.
Taking chemotherapy drugs is a serious health concern; contact your doctor before the date schedule for the therapy if you cannot go to the hospital for the treatment. Do not stay home because you are experiencing side effects; Aredia cause side effects in most patients.
Contraindication: Bisphosphonates have been associated with renal toxicity manifested as deterioration of renal function and potential renal failure. The risk of these complications increases when the drug with certain agents. Therefore, Aredia is contraindicated in cases of allergy to one of its constituents. Tell your doctor or pharmacist about any history of allergy to:
- skelid (tiludronate)
- etidronate (Didronel)
- alendronate (Fosamax)
- risedronate (Actonel)
- Zoledronic acid (Zometa).
Aredia is contraindicated in pregnancy or breastfeeding. See your doctor immediately if you become pregnant during the treatment; Aredia can cause serious problems to the fetus.
Before taking Aredia, tell your doctor if you have or had a history of thyroid surgery, seizures, liver or kidney disease, thyroid surgery or dental surgery. These factors may obligate him to prescribe another drug or change the way you should use the drug.
Interactions: Some products that may interact with Aredia are other bisphosphonates, such as alendronate; and other medications that affect the kidneys such as ibuprofen or naproxen. Make sure your doctor and pharmacist have a complete list of all the medication you are taking both by prescription and over the counter.
Side effects: Aredia may cause side effects which can be mild or severe, temporary or permanent. Most common Aredia side effects include: coughing; constipation; diarhoea; nausea and vomiting; heartburn; difficulty sleeping;abdominal or stomach pain; bone pain; dizziness; indigestion; loss of appetite; swelling of your hands, arms, feet, ankles, or lower legs; difficulty or painful urination; fatigue or general weakness; and Pain, redness, or swelling at the injection site.
Although rare, Aredia can cause serious side effects which require immediate medical attention; contact your doctor immediately if you experience any of these symptoms:
- shortness of breath
- eye pain or tearing
- fast heartbeat
- fainting
- vomiting blood
- jaw numbness and pain
- painful or swollen gums
- loosening of the teeth
- bloody or black and tarry stools
- sudden tightening of muscles
- numbness or tingling around your mouth or cheeks.
