Osteoporosis International

, Volume 4, Issue 6, pp 320–322

Pamidronate: An unrecognized problem in gastrointestinal tolerability

  • E. G. Lufkin
  • R. Argueta
  • M. D. Whitaker
  • A. L. Cameron
  • V. H. Wong
  • K. S. Egan
  • W. M. O'Fallon
  • B. L. Riggs
Original Article

Abstract

Pamidronate (aminohydroxypropylidine bisphosphonate, APD) is an effective agent for treatment of Paget's disease of bone, and it has also been thought to be effective for treatment of osteoporosis. We desired to study a newer, time-release preparation of pamidronate, and carried out a placebo-controlled, double-masked study of postmenopausal osteoporosis. The original formulation was in a rapidly dissolving gelatin capsule. We encountered four episodes of esophagitis in 49 enrolled patients. We therefore discontinued treatment with this preparation and later began the study again using a standard tablet preparation. We encountered an additional case of erosive esophagitis in 1 patient of 40 receiving this tablet preparation. No patient was receiving concomitant medication which could cause esophagitis. Two of the patients gave a past history of hiatal hernia and 1 gave a history of gastric ulcer 27 years previously. The diagnosis of esophagitis was confirmed in all cases by endoscopy. Healing of the esophagitis promptly ensued after discontinuation of the pamidronate and the use of antacid medication.

Keywords

Bisphosphonate toxicity Esophagitis Osteoporosis Pamidronate 

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Copyright information

© European Foundation for Osteoporosis 1994

Authors and Affiliations

  • E. G. Lufkin
    • 1
  • R. Argueta
    • 2
  • M. D. Whitaker
    • 2
  • A. L. Cameron
    • 3
  • V. H. Wong
    • 1
  • K. S. Egan
    • 4
  • W. M. O'Fallon
    • 4
  • B. L. Riggs
    • 1
  1. 1.Division of Endocrinology and MetabolismMayo Clinic and Mayo FoundationRochesterUSA
  2. 2.Division of Endocrinology and Internal MedicineMayo Clinic and Mayo FoundationScottsdale
  3. 3.Division of Gastroenterology and Internal MedicineMayo Clinic and Mayo FoundationRochester
  4. 4.Department of Health Sciences ResearchMayo Clinic and Mayo FoundationRochesterUSA

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