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Aredia Side Effects

Generic name: pamidronate

Medically reviewed by Drugs.com. Last updated on Dec 20, 2023.

Note: This document provides detailed information about Aredia Side Effects associated with pamidronate. Some dosage forms listed on this page may not apply specifically to the brand name Aredia.

Applies to pamidronate: intravenous powder for solution, intravenous solution.

Serious side effects of Aredia

Along with its needed effects, pamidronate (the active ingredient contained in Aredia) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking pamidronate:

More common

  • abdominal or stomach cramps
  • black, tarry stools
  • bloody in the urine or stools
  • blurred vision
  • chest pain
  • chills
  • confusion
  • convulsions (seizures)
  • decrease in the amount of urine
  • dizziness
  • drowsiness
  • fainting
  • fast or irregular heartbeat
  • fever
  • headache
  • increased thirst
  • loss of appetite
  • muscle pain, cramps, spasms, or twitching
  • nausea or vomiting
  • nervousness
  • noisy, rattling breathing
  • numbness or tingling in the hands, feet, or lips
  • pinpoint red spots on the skin
  • pounding in the ears
  • shortness of breath
  • slow or fast heartbeat
  • swelling of the fingers, hands, feet, or lower legs
  • trembling
  • troubled breathing at rest
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • weight gain

Less common

  • cough
  • dilated neck veins
  • extreme fatigue
  • irregular breathing
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • swelling
  • ulcers, sores, or white spots in the mouth

Rare

  • decreased vision
  • difficulty with swallowing
  • eye pain or tenderness
  • eye redness
  • hives
  • itching
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • sensitivity of the eye to light
  • skin rash
  • sweating
  • tearing of the eye
  • tightness in the chest

Incidence not known

  • bone, joint, or muscle pain, severe and occasionally incapacitating
  • faintness, or lightheadedness when getting up suddenly from a lying or sitting position

Other side effects of Aredia

Some side effects of pamidronate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • acid or sour stomach
  • belching
  • bladder pain
  • bloody or cloudy urine
  • body aches or pain
  • bone pain
  • constipation
  • cracks in the skin at the corners of mouth
  • diarrhea
  • difficult, burning, or painful urination
  • difficult or labored breathing
  • difficulty moving
  • ear congestion
  • fear
  • frequent urge to urinate
  • heartburn
  • indigestion
  • joint pain
  • lack or loss of strength
  • lower back or side pain
  • muscle aching, cramping, pains, or stiffness
  • nasal congestion
  • nervousness
  • pain and swelling at the injection site
  • sensitivity to heat
  • shivering
  • sneezing
  • soreness or redness around the fingernails and toenails
  • stomach discomfort, upset, or pain
  • sweating
  • swollen joints
  • trouble sleeping
  • weight loss

Less common

  • ammonia-like breath odor
  • feeling, seeing, or hearing things that are not there
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • feeling unusually cold
  • swelling or inflammation of the mouth
  • unusual behavior

For healthcare professionals

Applies to pamidronate: intravenous powder for injection, intravenous solution.

General

This drug has been generally well tolerated and many adverse effects that occurred during treatment may have been related to the underlying disease state. Adverse effects have been most often associated with larger (90 mg) doses of pamidronate (the active ingredient contained in Aredia) The most common adverse effect has been fever, occurring in up to 41% of patients. The fever was generally mild and transient. Onset was typically within the first 48 hours after infusion and resolution was within another 48 hours.[Ref]

Gastrointestinal

Genitourinary

Metabolic

Presentation of hypocalcemia may be delayed. In one case report, the patient presented with fingertip paresthesias and a serum calcium of 6.8 mEq/L (7.8 mEq/mL, corrected) 13 days after a single infusion of pamidronate.[Ref]

Musculoskeletal

Other

Respiratory

Cardiovascular

Dermatologic

Hematologic

Leukopenia was generally mild and transient. In one study, granulocytopenia occurred in 4.2% of patients but completely resolved after discontinuation of pamidronate therapy. Patients with anemia, leukopenia, or thrombocytopenia prior to initiation of pamidronate should be carefully monitored during the first 2 weeks of therapy.[Ref]

Local

Nervous system

Ocular

Uveitis generally occurs within 24 to 48 hours after administration of pamidronate (the active ingredient contained in Aredia) The uveitis may be bilateral, and reversible, partial 3rd and 4th nerve palsies have been reported with the uveitis. Recurrences have occurred with rechallenge of the drug. Therapy with pamidronate should be discontinued if uveitis occurs. Although severe cases have been reported, most symptoms have resolved on discontinuation of pamidronate with minimal or no intervention.

A nonspecific conjunctivitis has been reported with pamidronate use. The conjunctivitis may consist of any or all of the following symptoms: conjunctival hyperemia, irritation, epiphora, discharge, and blurred vision. These symptoms may appear within the first 6 to 48 hours after administration of the drug and generally resolve within a few days after drug discontinuation.[Ref]

Psychiatric

Renal

Endocrine

Hepatic

Hypersensitivity

References

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2. (2001) "Product Information. Aredia (pamidronate)." Novartis Pharmaceuticals

3. Purohit OP, Radstone CR, Anthony C, Kanis JA, Coleman RE (1995) "A randomised double-blind comparison of intravenous pamidronate and clodronate in the hypercalcaemia of malignancy." Br J Cancer, 72, p. 1289-93

4. Lourwood DL (1998) "The pharmacology and therapeutic utility of bisphosphonates." Pharmacotherapy, 18, p. 779-89

5. Cerner Multum, Inc. "UK Summary of Product Characteristics."

6. Cerner Multum, Inc. "Australian Product Information."

7. (2016) "Product Information. Pamidronate Disodium (pamidronate)." Teva Pharmaceuticals USA

8. Mautalen CA, Casco CA, Gonzalez D, Ghiringhelli GR, Massironi C, Fromm GA, Plantalech L (1984) "Side effects of disodium aminohydroxypropylidenediphosphonate (APD) during treatment of bone diseases." Br Med J (Clin Res Ed), 288, p. 828-9

9. Spivacow FR, Zanchetta JR, Kerzberg EM, Frigeri A, Fiasche R, Roldan EJA (1996) "Tolerability of oral pamidronate in elderly patients with osteoporosis and other metabolic bone diseases." Curr Ther Res Clin Exp, 57, p. 123-30

10. Theriault RL, Lipton A, Hortobagyi GN, Leff R, Gluck S, Stewart JF, Costello S, Kennedy I, Simeone J, Seaman JJ, Knight RD, (1999) "Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: A randomized, placebo-controlled trial." J Clin Oncol, 17, p. 846-54

11. Herrera JA, Sarabia MO, Gonzalez MM (1999) "Effects of treatment with bisphosphonates on gastrointestinal and esophageal mucosa in patients with osteoporosis: Pamidronate versus alendronate." Curr Ther Res Clin Exp, 60, p. 307-13

12. Jodrell DI, Iveson TJ, Smith IE (1987) "Symptomatic hypocalcaemia after treatment with high-dose aminohydroxypropylidene diphosphonate." Lancet, 1, p. 622

13. Lipton A, Theriault RL, Hortobagyi GN, Simeone J, Knight RD, Mellars K, Reitsma DJ, Heffernan M, Seaman JJ (2000) "Pamidronate prevents skeletal complications and is effective palliative treatment in women with breast carcinoma and osteolytic bone metastases - Long term follow-up of two randomized, placebo-controlled trials." Cancer, 88, p. 1082-90

14. Rosen CJ, Brown S (2003) "Severe hypocalcemia after intravenous bisphosphonate therapy in occult vitamin D deficiency." N Engl J Med, 348, p. 1503-4

15. Palmieri C, Dhillon T, Coombes C, Vigushin D (2004) "Hypocalcaemia after intravenous bisphosphonate: adjuvant bisphosphonate is not currently accepted practice." BMJ, 328, 1439; author reply 1439-40

16. Kellihan MJ, Mangino PD (1992) "Pamidronate." Ann Pharmacother, 26, p. 1262-9

17. Adamson BB, Gallacher SJ, Byars J, Ralston SH, Boyle IT, Boyce BF (1993) "Mineralisation defects with pamidronate therapy for paget's disease." Lancet, 342, p. 1459-60

18. Reid IR, Cundy T, Ibbertson HK, King AR (1994) "Osteomalacia after pamidronate for pagets disease." Lancet, 343, p. 855

19. Liens D, Delmas PD, Meunier PJ (1994) "Long-term effects of intravenous pamidronate in fibrous dysplasia of bone." Lancet, 343, p. 953-4

20. Malnick SD, Ariel-Ronen S, Evron E, Sthoeger ZM (1997) "Acute pseudogout as a complication of pamidronate." Ann Pharmacother, 31, p. 499-500

21. Bamias A, Kastritis E, Bamia C, et al. (2005) "Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors." J Clin Oncol, 23, p. 8580-7

22. Foley-Nolan D, Daly MJ, Williams D, Wasti A, Martin M (1992) "Pamidronate associated hallucinations." Ann Rheum Dis, 51, p. 927-8

23. Ghose K, Waterworth R, Trolove P, Highton J (1994) "Uveitis associated with pamidronate." Aust N Z J Med, 24, p. 320

24. Macarol V, Fraunfelder FT (1994) "Pamidronate disodium and possible ocular adverse drug reactions." Am J Ophthalmol, 118, p. 220-4

25. De S, Meyer P, Crisp AJ (1995) "Pamidronate and uveitis." Br J Rheumatol, 34, p. 479

26. Odonnell NP, Rao GP, Aguisfernandez A (1995) "Paget's disease: ocular complications of disodium pamidronate treatment." Br J Clin Pract, 49, p. 272-3

27. Stewart GO, Stuckey BGA, Ward LC, Prince RL, Gutteridge DH, Constable IJ (1996) "Iritis following intravenous pamidronate." Aust N Z J Med, 26, p. 414-5

28. Machado CE, Flombaum CD (1996) "Safety of pamidronate in patients with renal failure and hypercalcemia." Clin Nephrol, 45, p. 175-9

Further information

Aredia side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.