Treatment of Complications From Multiple Myeloma


The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications may help to prevent, reduce, or manage side effects of treatment. Talk to your doctor about any symptoms that you have from either the treatment or the medication.


Common names include:

  • Pamidronate
  • Clodronate
  • Erythropoietin

Multiple myeloma often damages the bones. Bisphosphonates are used to prevent bone pain and fractures by helping the body restore and repair bone that has been damaged by the growth of myeloma cells.

Pamidronate is given as an injection. Clodronate is given daily by mouth. These drugs are used in addition to chemotherapy. They work by blocking the further breakdown of bone.

Possible side effects include:

  • Nausea or vomiting
  • Decreased appetite
  • Bone, joint, or muscle pain
  • Fever (pamidronate)
  • Stomach pain (pamidronate)
  • Difficulty sleeping (pamidronate)
  • Cough, runny nose (pamidronate)
  • Fatigue (pamidronate)
  • Headache (pamidronate)
  • Anemia (pamidronate)
  • Diarrhea (clodronate)
  • Low calcium levels—hypocalcemia (clodronate)


Common names include:

  • Morphine
  • Oxycodone
  • Fentanyl
  • Hydromorphone
  • Methadone

Multiple myeloma can result in chronic and severe back pain. To relieve pain, the doctor may prescribe opioids. They are an effective group of medications if taken as prescribed and under a doctor's supervision. Your doctor will monitor you while you are taking them.

Possible side effects include:

  • Constipation
  • Sleepiness
  • Lightheadedness
  • Nausea or vomiting
  • Itchy skin

Serious side effects may include difficulty breathing and low blood pressure.

Other Treatments


Plasmapheresis may be done if your blood has become too thick from the presence of abnormal antibodies created by multiple myeloma. Plasmapheresis is a process that separates blood components, including the fluid part of the blood (plasma) that contains the abnormal antibodies.

Blood is taken out of the body through one of two tubes. It is spun in a machine that separates plasma from the rest of the blood. The blood cells are mixed with replacement plasma or a plasma substitute. The new mixed blood is then returned to the body through the other tube.

Plasmapheresis is used to help control symptoms of multiple myeloma. Results are not permanent, but the process can be repeated if needed.

Vertebroplasty and Balloon Kyphoplasty

Spinal compression fractures are a complication of multiple myeloma. This complication can result in severe back pain. During vertebroplasty, a special bone cement is injected into the broken vertebrae. In kyphoplasty, a balloon is used to expand the fractured area before injecting the cement. Both procedures restore some physical function of the spine and reduce pain.



Bisphosphonates for treatment and prevention of osteoporosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 4, 2016. Accessed March 16, 2017.
McGirt MJ, Parker SL, Wolinsky JP, Witham TF, Bydon A, Gokaslan ZL. Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine J. 2009;9(6):501-508.
Multiple myeloma. EBSCO DynaMed Plus website. Available at: Updated November 21, 2016. Accessed March 16, 2017.
Opioid abuse or dependence. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated January 17, 2017. Accessed March 16, 2017.
Spinal compression fractures. Cedars Sinai website. Available at: Accessed March 16, 2017.
Treatment option overview. National Cancer Institute website. Available at: Updated August 5, 2016. Accessed March 16, 2017.
Last reviewed March 2017 by Mohei Abouzied, MD, FACP
Last Updated: 5/6/2016


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