Aredia(pamidronate disodium), in conjunction with adequate hydration, is indicated for the treatment of moderate or severe hypercalcemia associated with malignancy, with or without bone metastases. Aredia(pamidronate disodium) is indicated for the treatment of patients with moderate to severe Paget's disease of bone. Aredia (pamidronate disodium) is indicated, in conjunction with standard antineoplastic therapy, for the treatment of osteolytic bone metastases of breast cancer and osteolytic lesions of multiple myeloma. Due to the risk of clinically significant deterioration in renal function, which may progress to renal failure, single doses of Aredia(pamidronate disodium) should not exceed 90 mg and the duration of infusion should be no less than 2 hours. Risk factors for the deterioration of renal function include elevated baseline creatinine and multiple cycles of bisphosphonate treatment.

Osteonecrosis of the Jaw (ONJ) has been reported in patients with cancer receiving treatment including bisphosphonates, chemotherapy, and/or corticosteroids. A dental examination with appropriate preventive dentistry should be considered prior to treatment with bisphosphonates in patients with concomitant risk factors. While on treatment, these patients should avoid invasive dental procedures if possible. The most common adverse events in bone metastases clinical trials regardless of causality were as follows: Fluid overload, generalized pain, hypertension, abdominal pain, anorexia, constipation, nausea, vomiting, urinary tract infection, bone pain, fever, back pain, arthrosis, headache, anemia, hypocalcemia, arthralgias, myalgias, and dyspnea.

Aredia(pamidronate disodium) is not recommended in patients with severe renal impairment. Serum creatinine should be measured before each dose and treatment should be withheld for renal deterioration. Aredia(pamidronate disodium) is excreted intact primarily via the kidney, and the risk of renal adverse reactions may be greater in patients with impaired renal function. Patients who receive Aredia(pamidronate disodium) should have serum creatinine assessed prior to each treatment. In patients receiving Aredia(pamidronate disodium) for bone metastases, who show evidence of deterioration in renal function, Aredia(pamidronate disodium) treatment should be withheld until renal function returns to baseline.