Bisphosphonates for Metastatic Cancer

Examples

Generic Name Brand Name
pamidronate Aredia
zoledronic acid Zometa

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.

How It Works

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.

Why It Is Used

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.

How Well It Works

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

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Severe bone pain.

Common side effects of this medicine include:

  • Nausea and vomiting.
  • Fatigue.
  • Dizziness.
  • Constipation.
  • Flu-like symptoms, including fever, headache, and muscle or joint pain.

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

What To Think About

Bisphosphonates are not usually recommended for people with severe kidney disease. Your doctor will test your kidney function before prescribing bisphosphonates, especially if you are considering zoledronic acid (Zometa).

Some people who take bisphosphonates have problems with bone decay or delayed bone healing, particularly in the jaw. If you are taking bisphosphonates and need dental surgery, talk with your doctor about the risk of problems with bone healing.

Tell your doctor if you notice pain in your thigh or groin. Some research suggests that taking bisphosphonates for a long time may slightly increase the risk of breaking the thigh bone.

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.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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

References

Citations

  1. Abernathy A, Foley KM (2011). Management of cancer pain. In VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 9th ed., pp. 2426–2447. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Sarah Marshall, MD - Family Medicine
Douglas A. Stewart, MD - Medical Oncology
Last Revised August 14, 2013

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