What is the use of Inandronate (Pamidronate)?

From the Guidelines

Ibandronate (not Inandronate) is a bisphosphonate medication primarily used to treat and prevent osteoporosis in postmenopausal women. It works by slowing bone loss while increasing bone mass, which helps reduce the risk of fractures. The standard dosing is either 150 mg taken orally once monthly or 3 mg given as an intravenous injection every three months. When taking the oral form, patients must remain upright for at least 60 minutes after administration and take it with a full glass of water on an empty stomach (at least 60 minutes before the first food or drink of the day) to ensure proper absorption and reduce the risk of esophageal irritation. Common side effects include back pain, heartburn, stomach pain, and flu-like symptoms, particularly after the first dose. Ibandronate functions by binding to bone mineral and inhibiting osteoclast activity, the cells responsible for breaking down bone tissue. This medication is particularly beneficial for individuals with significant bone loss or those at high risk for fractures, though it should be used with caution in patients with kidney problems or low calcium levels.

Key Points

• Ibandronate is used to treat and prevent osteoporosis in postmenopausal women.
• The standard dosing is either 150 mg orally once monthly or 3 mg intravenously every three months.
• Patients should remain upright for at least 60 minutes after administration and take it with a full glass of water on an empty stomach.
• Common side effects include back pain, heartburn, stomach pain, and flu-like symptoms.
• Ibandronate should be used with caution in patients with kidney problems or low calcium levels, as stated in the guidelines by the American Society of Clinical Oncology 1.

Monitoring and Duration of Therapy

• Serum creatinine should be monitored before each dose of pamidronate or zoledronic acid, as recommended by the American Society of Clinical Oncology 1.
• The optimal duration of bisphosphonate therapy has not been well defined, but the American Society of Clinical Oncology suggests continuing therapy until there is evidence of a substantial decline in a patient’s general performance status 1.
• The use of biochemical markers of bone metabolism to monitor bisphosphonate use is not suggested for routine care, as stated in the guidelines by the American Society of Clinical Oncology 1.

Special Considerations

• Patients with pre-existing renal disease should be monitored closely, and the dose of pamidronate or zoledronic acid should be adjusted accordingly, as recommended by the American Society of Clinical Oncology 1.
• Patients with osteonecrosis of the jaw should be managed carefully, and the use of bisphosphonates should be avoided if possible, as stated in the guidelines by the American Society of Clinical Oncology 1.
• The role of bisphosphonates in pain control secondary to bony involvement is recommended for patients with pain due to osteolytic disease, as stated in the guidelines by the American Society of Clinical Oncology 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Inandronate Overview

• Inandronate is not directly mentioned in the provided studies, however, information about other bisphosphonates can be found.
• Bisphosphonates, such as ibandronate, are a class of drugs used to treat osteoporosis and other bone diseases 2, 3, 4, 5.

Ibandronate Studies

• Ibandronate has been shown to be effective in reducing the risk of vertebral fractures in postmenopausal women with osteoporosis 3, 4, 5.
• The drug can be administered orally or intravenously, with intermittent dosing regimens that may improve treatment adherence and persistence 3, 4, 5.
• Studies have demonstrated the efficacy and safety of ibandronate given by intravenous injection once every 3 months 5.

Bisphosphonate Treatment

• Bisphosphonates accumulate in bone and provide some residual antifracture reduction when treatment is stopped 2.
• The duration of treatment and length of the holiday are based on fracture risk and pharmacokinetics of the bisphosphonate used 2.
• Patients at mild risk might stop treatment after 5 years and remain off as long as bone mineral density is stable and no fractures occur 2.

Other Bisphosphonates

• Etidronate, another bisphosphonate, has been used to treat primary osteoporosis and other demineralizing bone diseases, although its use is not approved in the United States 6.
• Etidronate has a worldwide reputation as a relatively inexpensive, efficacious, and highly tolerable treatment for osteoporosis 6.