Pamidronate use while Breastfeeding
Drugs containing Pamidronate: Aredia
Pamidronate Levels and Effects while Breastfeeding
Summary of Use during Lactation
Limited information indicates that maternal doses of pamidronate of 30 mg intravenously produce very low levels in milk. Because pamidronate has a serum half-life of about 3 hours, is highly bound to calcium and is poorly absorbed orally (0.3 to 3% in adults), absorption of pamidronate by a breastfed infant is unlikely.[1] Until more data become available, withholding nursing for 12 to 24 hours after a dose should ensure that the breastfed infant is exposed to little or no pamidronate. Other evidence indicates that breastfeeding after cessation of long-term pamidronate treatment appears to have no adverse effects on the infant.
Drug Levels
Maternal Levels. A woman who was 6 months postpartum received a single intravenous dose of pamidronate 30 mg. She pumped her breasts for 48 hours after the dose and collected the milk in 2 portions for analysis: 0 to 24 hours and 25 to 48 hours. Pamidronate was not detected (<94 mcg/L) in either portion of breastmilk.[1]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
A mother received intravenous pamidronate 30 mg once monthly beginning 6 months postpartum. She pumped her breasts and discarded the milk for 48 hours after each dose. The infant, who was about 80% breastfed throughout maternal pamidronate therapy, remained healthy and grew normally during this time.[1]
Because pamidronate can persist in the body for years after long-term administration, the following cases may be relevant. Three women received pamidronate intravenously for osteogenesis imperfecta or McCune-Albright syndrome in cumulative dosages of 6, 7.5 and 9 mg/kg annually for 2 years, 4 years, and 2.2 years, respectively. Their last doses were 3 months, 3 and 48 months (2 infants), and 21 months prior to conception, respectively. None of the women resumed pamidronate during breastfeeding, but they all breastfed their infants postpartum, one for 18 months, two for undetermined times, and one for 6 weeks. None of the infants had any evidence of adverse effects of pamidronate.[2]
Possible Effects on Lactation
Relevant published information was not found as of the revision date.
References
1. Siminoski K, Fitzgerald AA, Flesch G, Gross MS. Intravenous pamidronate for treatment of reflux sympathetic dystrophy during breastfeeding. J Bone Min Res. 2000;15:2052-5. PMID: 11028460
2. Chan B, Zacharin M. Maternal and infant outcome after pamidronate treatment of polyostotic fibrous dysplasia and osteogenesis imperfecta before conception: a report of four cases. J Clin Endocrinol Metab. 2006;91:2017-20. PMID: 16551739
Pamidronate Identification
Substance Name
CAS Registry Number
40391-99-9
Drug Class
- Bisphosphonates
- Bone Density Conservation Agents
- Diphosphonates
Administrative Information
LactMed Record Number
502
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
2010-07-09
Disclaimer
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
See Also...
- Pamidronate use during Pregnancy
- Pamidronate Consumer Information
- Breastfeeding Support Group
- Safe Medications during Breastfeeding
- Medicine use while Breastfeeding
- Medicine use during Pregnancy
Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.
