Bisphosphonate Treatment
- All patients with myeloma will benefit from regular bisphosphonate treatment.
- Pamidronate is preferred over Zoledronic acid because of a lower instance of osteonecrosis of the jaw.
- A dental review is required before commencing bisphosphonate therapy if time allows.
- Pamidronate 30 mg IV every 4 weeks is the standard dose.
- Pamidronate could be stopped or reduced in frequency at two years if myeloma is inactive i.e. in stable plateau phase.
- Patients with active disease at the two year mark could continue bisphosphonate therapy. Consider a reduced frequency of administration (3 monthly).
Note: IV bisphosphonates are more effective than oral bisphosphonates.
Topic Code: 5590