Hormones and Agents Affecting Hormonal Mechanism: Calcium Regulating Agents
IPAMI2 “Pamisol injection” 3 mg/ml; 5 ml/vial
適應症：惡性腫瘤之蝕骨性骨頭轉移、惡性高血鈣症。
Usual dose:
Adult：
Bone metastasis, osteolytic: 90 mg IV administered as a 4-h infusion on a monthly basis.
Hypercalcemia of malignancy (moderate to severe), With adequate hydration: moderate, 60-90 mg IV as a single dose infused over 2-24 h; may repeat after a minimum of 7 days; severe, 90 mg IV as a single dose infused over 2-24 h; may repeat after a minimum of 7 days.
Paget’s disease (moderate to severe): 30 mg IV over 4 h daily for 3 consecutive days (total dose, 90 mg); may retreat with same dose when clinically indicated.
Pediatric: N/A, yet single doses of IV pamidronate should not exceed 90 mg in order to decrease the risk of deterioration in renal function.
Contraindication:
Hypersensitivity to pamidronate, other bisphosphonates, or mannitol.
Precaution:
Electrolyte abnormalities (eg, calcium, phosphate, magnesium, potassium levels), osteonecrosis of the jaw, atypical femoral fractures, renal toxicity.
Adverse effect:
Common: injection site reaction, hypocalcemia, hypokalemia, hypomagnesemia, hypophosphatemia, loss of appetite, nausea, vomiting, anemia, fever.
Serious: arthralgia, bone necrosis of the jaw, bone pain, myalgia, seizure, deteriorating renal function.
健保使用規範：限符合下列條件之一患者使用：（85/1/1、87/4/1、93/2/1、96/1/1、100/1/1）
1.血清鈣濃度超過2.75 mmol/L (11.0mg %) 或游離鈣大於5.6 mg /dL者。
2.惡性腫瘤之蝕骨性骨頭轉移之病患，在使用嗎啡、可待因等止痛劑後仍不易控制者。
3.Multiple Myeloma, Breast Cancer, Prostate Cancer併有蝕骨性骨轉移之病患(96/1/1)。