Aredia (pamidronate disodium)

What is Aredia? 

AREDIA® is a bisphosphonate medication that prevents bone damage in multiple myeloma patients. Normally, our body has a delicate balance between cells that build bone (osteoblasts) and cells that break down bone (osteoclasts). For myeloma patients, signals sent by cancerous cells stimulate osteoclasts and disrupt this balance causing excess bone breakdown. 

Myeloma patients may experience various bone problems called skeletal-related events, or SREs, including  

• weak bones,  
• lytic lesions (holes in the bones),  
• and fractures.  

In a clinical trial of 392 patients receiving either Aredia or a placebo, patients who received Aredia were less likely to develop an SRE than those who received the placebo (24% vs. 41%). In addition, patients receiving Aredia went a longer time before developing an SRE, and the SRE events were less likely to be severe¹.

Who is a candidate for Aredia? 

Aredia is indicated for treating osteolytic lesions in patients with multiple myeloma.  

Aredia may not be recommended by your clinician if you have impaired kidney (renal) function or have a known allergy to bisphosphonates. You may also be unable to take Aredia if you are pregnant or breastfeeding.  

There are other reasons you may not be a candidate for Aredia. Please see the package insert and discuss Aredia with your doctor for more information. 

How is Aredia given? 

The typical dose of Aredia is 90 mg, given through an infusion into a vein. The infusion usually lasts 4 hours and is given every 3 to 4 weeks. 

Your clinician may recommend taking calcium and Vitamin D supplements while taking Aredia. Your clinician will measure your vitamin D and calcium levels before treatment.

• fatigue, 
• weakness (asthenia),  
• fever, 
• metastases,  
• loss of appetite,  
• GI side effects (such as nausea, constipation, diarrhea, vomiting, and abdominal pain),  
• Muscle pain,  
• joint pain/stiffness,  
• anxiety,  
• headache,  
• insomnia,  
• coughing, 
• shortness of breath,  
• pleural effusions,  
• sinusitis,  
• upper respiratory tract infections,  
• urinary tract infections,  
• and blood-related changes such as  
  • low levels of red blood cells (anemia),  
  • low white cells called granulocytes (granulocytopenia),  
  • and platelets (thrombocytopenia).² 

It is important to know that many side effects in patients taking Aredia also occurred in patients taking a placebo. In addition, many side effects seen in clinical trials are symptoms that can occur because of myeloma. Therefore, these side effects may not be caused by the medication.  

Aredia may cause severe side effects in some people. In a clinical trial of 392 patients, five patients experienced serious side effects related to Aredia:  

• worsening kidney function (3),  
• respiratory distress (1),  
• and an allergic reaction (1)³

Your kidneys eliminate Aredia from your body. Therefore kidney-related side effects can occur. The risk of kidney-related side effects may be increased if you are taking Aredia in combination with thalidomide.⁴ Your clinician will take bloodwork to monitor your creatinine (a measure of your kidney function) before and throughout treatment.  

In addition, your clinician will monitor your blood electrolyte levels (or minerals in your body) as Aredia may cause changes in these levels (for example, low phosphorus, potassium, magnesium, and calcium). 

Like other bone-targeting medications, Aredia may cause osteonecrosis of the jaw (ONJ) or opening of areas of the jawbone. You will be advised to have a complete dental exam before starting treatment. ONJ may cause you to feel  

• pain,  
• numbness,  
• unusual drainage,  
• or swelling from your jaw, mouth, or teeth.  

If you experience any of these symptoms while taking Aredia, it is important to contact your doctor. 

For a complete list of side effects, please see the Aredia package insert and consult the additional resources below. 

Additional information 

FDA package insert: Aredia 

Efficacy of Pamidronate in Reducing Skeletal Events in Patients with Advanced Multiple Myeloma.