Bisphosphonates for metastatic cancer

Pamidronate and zoledronic acid are given in IVs (intravenously) to treat cancer that has spread to the bone. Usually treatment is needed only once a month.

Cancer cells that have spread to the bone upset the normal cellular activity in the bone. Bisphosphonates slow the activity of these cancer cells and help to reduce the breakdown of the bone. This relieves pain and helps keep bones from breaking.

Bisphosphonates are used to treat bone pain caused by cancer that has spread to bone (bone metastasis). They also help reduce pain from cancers that begin in the bone, such as multiple myeloma.

Bisphosphonates decrease fractures and relieve bone pain in people who have cancer that has spread to the bones or multiple myeloma.¹

Side effects of bisphosphonates can include:

• Abdominal pain, heartburn, or increased gas.
• Nausea.
• Diarrhea or constipation.
• Flu-like symptoms, including headache and muscle or joint pain.

Possible side effects that can occur but are not common include:

• Increased bone pain. This tends to be related to the amount used.
• The slowing of new bone growth. Lowering the amount used may reduce this side effect.

Serious problems with bone healing, particularly after dental surgery, have been found in some people taking bisphosphonates.² If you are taking bisphosphonates and need dental surgery, talk with your doctor about the risk of problems with bone healing.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Your doctor may suggest that you take calcium and vitamin D supplements while taking bisphosphonates to help keep your bones strong. But be sure to talk with your doctor before taking a vitamin or mineral supplement, because some minerals can interfere with the way these drugs work.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Citations

1. Foley KM (2005). Management of cancer pain. In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 7th ed., pp. 2615–2649. Philadelphia: Lippincott Williams and Wilkins.

2. Marx RE, et al. (2005). Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: Risk factors, recognition, prevention, and treatment. Journal of Oral and Maxillofacial Surgery, 63(11): 1567-1575.

Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated November 17, 2005
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Douglas A. Stewart, MD - Medical Oncology
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