Abstract
Pamidronate (pamidronic acid) is an aminobisphosphonate that interferes with the mevalonate pathway inducing osteoclast-apoptotic cell death. A 90mg dose of pamidronate administered in a 2- to 24-hour infusion achieves normocalcemia in >90% of unselected patients. Zoledronate (zoledronic acid) is more effective than pamidronate in normalising calcium levels in patients with tumor-induced hypercalcemia, at least in patients without bone metastases; however, zoledronate should be used with caution in patients with renal insufficiency. Pamidronate can be safely administered in hypercalcemic patients with renal insufficiency. Clinically meaningful bone pain relief occurs in about half of patients treated with pamidronate.
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