Bone biopsies consistently show histological and histomorphometric improvement indicating the reversal of the disease process. Symptoms improve even in those with severe disease. Plasma concentrations of pamidronate rise rapidly after infusion is started and fall rapidly when the infusion is stopped. The apparent plasma half-life is about 0.8 hour. Pamidronate has a strong affinity for calcified tissues, and total elimination is not observed within the timeframe of experimental studies.
Retention is similar after each dose of pamidronate.
Thus, accumulation in bone is not capacity limited and is dependent solely on the cumulative dose. Impaired liver function is not expected to influence the pharmacokinetics of pamidronate as hepatic and metabolic clearance of pamidronate are insignificant. Pamidronate thus displays little potential for interactions with other drugs either at the metabolic or protein binding level. Tumor-induced hypercalcemia following adequate saline rehydration. Prior to treatment with pamidronate, renal excretion of excess calcium should be promoted by restoring and maintaining adequate fluid balance and urine output.