Last update Dec. 29, 2022

Pamidronate Disodium

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Pamidronate is an aminobisphosphonate that, like other bisphosphonates, inhibits bone resorption. It is used to treat Paget's disease, severe hypercalcemia, and osteolytic bone lesions associated with malignancy. It is administered by slow intravenous infusion every day or every 3 to 4 weeks depending on the disease.

Pamidronate is excreted in breast milk in undetectable concentration. (Siminoski 2000)

Most bisphosphonates are acidic compounds that achieve low plasma concentration. Both features make it unlikely excretion into the milk in clinically significant amount. Intestinal absorption of bisphosphonates is very low even during fasting and is considered negligible in the presence of milk due to formation with the calcium of non absorbable compounds.

No problems have been observed in infants of mothers treated with pamidronate (Mastaglia 2010, Shenker 2010, Chan 2006, Siminoski 2000),except some cases of mild and asymptomatic hypocalcemia in infants whose mothers had been already treated before and / or during pregnancy (Hassen 2010, Munns 2004), so some authors suggest regular monitoring of serum calcium. (Green 2014, Stathopoulos 2011)

Most osteoporosis treatments are compatible with breastfeeding.


See below the information of these related products:

  • Maternal Cancer ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Maternal osteoporosis ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Alternatives

We do not have alternatives for Pamidronate Disodium since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pamidronate Disodium is also known as


Pamidronate Disodium in other languages or writings:

Group

Pamidronate Disodium belongs to this group or family:

Tradenames

Main tradenames from several countries containing Pamidronate Disodium in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. < 3 %
Molecular weight 369 daltons
Protein Binding 54 %
pKa 0.67 -
28 ± 7 hours

References

  1. Green SB, Pappas AL. Effects of maternal bisphosphonate use on fetal and neonatal outcomes. Am J Health Syst Pharm. 2014 Abstract
  2. Stathopoulos IP, Liakou CG, Katsalira A, Trovas G, Lyritis GG, Papaioannou NA, Tournis S. The use of bisphosphonates in women prior to or during pregnancy and lactation. Hormones (Athens). 2011 Abstract Full text (link to original source) Full text (in our servers)
  3. Shenker NG, Shaikh MF, Jawad AS. Transient osteoporosis associated with pregnancy: use of bisphosphonate in treating a lactating mother. BMJ Case Rep. 2010 Abstract Full text (link to original source) Full text (in our servers)
  4. Hassen-Zrour S, Korbâa W, Béjia I, Saidani Z, Bergaoui N. Maternal and fetal outcome after long-term bisphosphonate exposure before conception. Osteoporos Int. 2010 Abstract
  5. Mastaglia SR, Watman NP, Oliveri B. Intravenous bisphosphonate treatment and pregnancy: its effects on mother and infant bone health. Osteoporos Int. 2010 Abstract
  6. 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 Abstract Full text (link to original source) Full text (in our servers)
  7. Munns CF, Rauch F, Ward L, Glorieux FH. Maternal and fetal outcome after long-term pamidronate treatment before conception: a report of two cases. J Bone Miner Res. 2004 Abstract Full text (link to original source) Full text (in our servers)
  8. French AE, Kaplan N, Lishner M, Koren G. Taking bisphosphonates during pregnancy. Can Fam Physician. 2003 Abstract Full text (link to original source) Full text (in our servers)
  9. Siminoski K, Fitzgerald AA, Flesch G, Gross MS. Intravenous pamidronate for treatment of reflex sympathetic dystrophy during breast feeding. J Bone Miner Res. 2000 Abstract Full text (link to original source) Full text (in our servers)

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