Adverse reactions with pamidronic acid are usually mild and temporary. The most frequent adverse reactions are asymptomatic hypocalcemia and fever (1-2 ° C body temperature increase), usually developing in the first 48 hours after the infusion of the drug. The fever usually passes independently and does not require treatment.
Criteria for assessing the incidence of adverse events: "very often" - ≥10%, "often" from ≥1% to <10%, "sometimes" from ≥ 0.1% to <1%, "rarely" - from ≥ 0.01% to <0.1%, "very rarely" - <0.001%, including individual messages.
From the side of the blood and lymphatic system: often - anemia, thrombocytopenia, lymphocytopenia; very rarely - leukopenia.
From the immune system: sometimes allergic reactions, including anaphylactoid reactions, bronchospasm / dyspnea, Quincke's edema; very rarely - anaphylactic shock.
From the nervous system: often - paresthesia, tetany (as manifestations of hypocalcemia), headache, insomnia or increased drowsiness; sometimes - cramps, agitation, dizziness; very rarely - confusion, visual hallucinations.
From the sense organs: often - conjunctivitis; sometimes - uveitis (iritis, iridocyclitis); very rarely - scleritis, episcleritis, xanthopsia (vision of objects in yellow color).
From the cardiovascular system: often marked increase in blood pressure (BP); sometimes - a marked decrease in blood pressure; very rarely - dyspnea, pulmonary edema (as signs of left ventricular failure), edema (as a sign of congestive heart failure) due to overload of the injected fluid.
From the gastrointestinal tract: often - nausea, vomiting, anorexia, abdominal pain, diarrhea, constipation, gastritis; sometimes - dyspepsia.
From the skin: often - a rash; sometimes itching.From the musculoskeletal system: often - transient pain in the bones, pain in the joints, myalgia; sometimes - muscle spasms.
From the urinary system: sometimes - acute renal failure; rarely - focal segmental glomerulosclerosis,including collapoid variant, nephrotic syndrome; very rarely - exacerbation of concomitant kidney disease, hematuria.
Exacerbation of infectious diseases: very rarely - reactivation of latent viral infections (Herpes simplex, Herpes Zoster).
Local reactions: often - pain, redness, swelling, denseness, phlebitis, thrombophlebitis at the injection site.
Laboratory indicators: very often - hypocalcemia, hypophosphatemia; often hypokalemia, hypomagnesemia, increased serum creatinine concentration; sometimes - changes in functional liver samples, increased urea concentration in blood serum; Very rarely - hyperkalemia, hypernatremia
Other: very often - fever and flu-like symptoms, sometimes accompanied by malaise, chills, a sense of fatigue and tidal flare.
Very rarely - the development of osteonecrosis (mainly the jaw, usually after extraction of the tooth or other dental intervention). A clear causal relationship between the development of osteonecrosis is not established.