The drug Pamifos is used to treat diseases in adults, which are accompanied by excessive osteoclast activity: hypercalcemia, which is caused by malignant tumors; Paget’s disease; metastases of malignant tumors in the bones (in most of the osteolytic type) and multiple myeloma (myeloma).
Pamifos composition and form of release
The drug is available in the form of a colorless solution without visible particles for infusion. The main component of the drug is sodium pamidronate pentahydrate 3 mg (in 1 ml of solution), as auxiliary substances in the composition are indicated: concentrated hydrochloric acid, water for injection, sodium hydroxide. The package contains one glass bottle of 90 mg.
Pamifos is a drug that affects the mineralization and structure of bones, reduces the severity of hypercalcemia, slows down or eliminates the increase in skeletal changes, as well as their consequences, such as: spinal cord compression, fractures, hypercalcemia, the need for surgery and radiation therapy. It is an inhibitor of bone resorption that osteoclasts have. The drug also reduces pain caused by damage to the bones, in combination with planned anticancer therapy, there was a slowdown in the development of bone metastases.
Indications for use
The drug Pamifos is used to treat diseases in adults, which are accompanied by excessive osteoclast activity:
- hypercalcemia, which is caused by malignant tumors;
- Paget’s disease;
- metastases of malignant tumors in the bones (in most of the osteolytic type) and multiple myeloma (myeloma).
The use of the drug is contraindicated if the patient has hypersensitivity to the constituent substances of the solution, severe renal failure and in childhood.
Application during pregnancy and lactation
The use of the drug during pregnancy and women who are breastfeeding is contraindicated.
Method of administration and dosage
Before use, the drug Pamifos is additionally diluted with 0.9% sodium chloride solution or 5% glucose solution.
The solution is injected slowly, intravenously, in the form of a 2-hour infusion, 250 ml of solution contains 90 mg of the drug. With hypercalcemia and myeloma, the solution is administered as a 4-hour infusion, 500 ml of the solution contains 90 mg of the drug.
In case of metastases of malignant tumors in the bones (in most of the osteolytic type) and multiple myeloma, the drug is used as a single infusion at a dose of 90 mg with an interval of 4 weeks. For patients on chemotherapy, infusions are given every 3 weeks.
In Paget’s disease, the dose of the drug is 180-210 mg. It is administered as 6 infusions (30 mg once a week) or as 3 infusions (60 mg every other week), if it concerns a dose of 180 mg. If a dose of 60 mg is planned for one infusion, then a dose of 30 mg is used for the first injection every 2 weeks, this is a 210 mg dose. Until remission of the disease or in case of exacerbation is achieved, this dosing regimen is repeated six months later, but the first dose of 30 mg is already skipped.
In case of hypercalcemia caused by malignant tumors, it is recommended to rehydrate the patient with 0.9% sodium chloride solution. The total volume of the dose of the drug used during the course of treatment depends on the initial level of calcium in the patient’s blood. If the calcium saturation in the blood is less than 3 mmol / l, the total dose is 15-30 mg of the drug. With a blood calcium saturation of 3 – 3.5 mmol / l, the total dose is 60–90 mg of the drug. With a calcium saturation in the blood of 3.5-4 mmol / l, the total dose is 30-60 mg of the drug. With a calcium saturation in the blood of more than 4 mmol / l, the total dose is 90 mg of the drug. The total dose can be administered as a single infusion, or as several infusions, with an interval of 2-4 days. The maximum permissible dose is 90 mg.
An overdose of the drug can cause: hypocalcemia, paresthesia, arterial hypotension and tetany. Overdose symptoms are eliminated with calcium gluconate infusion.
When using the drug, the most common side effects are: hypocalcemia, anemia, fever, thrombocytopenia, paresthesia, lymphocytopenia, tetany, conjunctivitis, insomnia, headache and drowsiness. Also, a rash, flu-like symptoms, at the infusion site may occur: pain, swelling, redness, phlebitis, induration and thrombophlebitis. Frequent negative reactions to the use of the drug are: hypomagnesemia, hypokalemia, increased saturation of creatinine in the blood, myalgia, arthralgia, transient bone pain.
Sometimes the use of this drug can cause: anaphylactic shock, allergic reactions, shortness of breath, bronchospasm, Quincke’s edema, convulsions, anxiety, dizziness. Also lethargy, dyspepsia, itching, muscle spasms, acute renal failure, glomerulosclerosis, hypophosphatemia. Possible changes in liver function tests, uveitis, increased blood urea saturation, arterial hypertension and hypotension, constipation, nausea, anorexia, vomiting, abdominal pain, gastritis, diarrhea.
In exceptional cases, disorientation, scleritis, visual hallucinations, episcleritis, shortness of breath, hematuria, xanthopsia, complications of concomitant kidney diseases, congestive heart failure, and malaise may occur.
Storage conditions and periods
The drug Pamifos must be stored in its original packaging, the temperature at the storage place should not exceed + 25 ° C, away from children. Cannot be frozen. Store the prepared solution for no more than 24 hours at room temperature. The shelf life is 4 years from the date of issue.