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Bisphosphonates

Bisphosphonates are a class of medications that can prevent loss of bone mass.

Bone is replaced on a cellular level quite often.

Certain cells help in this process such as: osteoblasts and osteoclasts.

Uses of this medication include:

  –  Osteoporosis
  –  Paget’s disease of bone (osteitis deformans)
  –  Osteogenesis imperfect
  –  Bone cancer
  –  Multiple Myeloma
  –  other cancers

Method of Action

  –  Slows down the breakdown of bone

Two classifications of medicine

1.)  N-containing bisphosphonates
2.)  Non-N-containing bisphosphonates

N-containing bisphosphonates

  –  Bind to enzymes necessary for the breakdown of bone and cause a block of the activity of that enzyme.

1.)   Sodium Alendronate  [Fosamax]

– Given 10mg every day or
– Given 70mg once a week

2.)   Risedronate   [Actonel]

– Given 5mg every day or
– Given 35mg once a week

3.)   Ibandronate  [Boniva

  –  Given once a month

4.)   Zoledronic Acid  [Zoledronate, Zometa]

  –  Given different doses depending on the diagnosis
  –  Used in patients with cancers such as multiple myeloma and prostate cancer to prevent cancer

5.)   Pamidronate   [Aredia]

6.)   Neridronate

7.)   Olpadronate

Non-N-containing Bisphosphonates

  –  Are metabolized in cells and transformed into compounds that affect bone destruction

1.)   Etidronate  [Didronel]

2.)   Tiludronic  [Skelid]

3.)   Clodronate

Side Effects

– Stomach pain
– Nausea
– Fatigue
– Irritation of esophagus
– Necrosis of jaw
– Joint pain
– Muscle pain
– others