Pharmacokinetics and pharmacodynamics of pamidronate disodium in hemodialysis.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:565A 1997
Pamidronate is a bisphosphonate with anti-resorptive effects on the bone similar to alendronate (Fosamax- TM). It is given intravenously and is approved for the treatment of hypercalcemia in patients with malignancy. Since it is renally excreted its use is said to be risky when the creatinine is > 5 mg%.
These authors treated 11 hypercalcemic dialysis patients with a single dose of 1.25 mg/kg (maximum dose 90 mg) given intravenously in saline over the first hour to hour and a half of dialysis. The t1/2 of the drug during dialysis was 1.4 hours. Calcium fell over several days with the greatest fall observed at an average of 5 (range 2-14) days after dosing. Calcium fell from a mean of 1.40 to 1.14 mmol/l in this time. No adverse effects were noted.
Comment: This is an important study and a complete report will be useful. Based on their data it seems likely that repeated dosing would be possible for chronic therapy. However, further information is needed to document the dosing interval and safety. It appears likely that this agent will be of value in patient care. (Donald Sherrard, M.D., University of Washington)
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ASN 30th Annual Meeting, San Antonio
CRF by problem area : Bone disease/aluminum