Bisphosphonates

Bisphosphonates are a class of drug that is used to delay the onset of the bone density loss caused by osteoporosis and other related conditions. They have been used in the treatment of bone loss disorders since the 1960s and work by being absorbed into the bones, destroying osteoclasts, the cells that are responsible for the destruction of bone tissue.

Osteoclasts exist in all people, selectively destroying bone cells so that new ones can be created. This keeps the bones in a constant state of renewal. After doing their job, the oconoclasts then die. When a bone loss disorder exists, osteoclasts do not die, but rather continue to destroy bone tissue. Bisphosphonates help to restore this balance, by encouraging osteoclasts to die, thus encouraging the body to continue the production of new bone.

This article will discuss the primary bisphosphonates that are in use today, along with the side effect profiles associated with them.

Etidronate
Brand name: Didronel
Etidronate is used to trigger the bones into the formation of new tissue by reversing the degeneration cycle. However, it is not meant to be used as a long term solution to treat osteoporosis as sustained use can lead to an excess of calcium building up in the bones.

Tiludronate
Brand name: Skelid
Tiludronate is used in the treatment of Paget's disease, a condition that causes the bones to enlarge and become brittle. It is taken with a glass of plain water to maximize the absorption into the bones. Tiludronate is known to interact with other bisphosphonates, reducing their effectiveness. It should only be taken during pregnancy if absolutely necessary. Diarrhea and headache two the most commonly reported side effects.

Pamidronate
Brand name: Aredia
In addition to treating osteoporosis, Pamidronate is also used to alleviate the bone loss caused by some forms of cancer. It is administered intravenously, and can have a rather unpleasant side effect profile including headache, fever, fatigue, and nausea.

Alendronate
Brand name: Fosamax
Alendronate is extremely popular for the treatment or prevention of the osteoporosis that commonly occurs in women after menopause. It is sold with and without vitamin D supplementation, and in several different dosages. Alendronate is favored by many doctors due to its very mild side effect profile.

Ibandronate
Brand names: Boniva, Bondronat, Bonviva
Ibandronate is approved by the FDA to be used in the treatment and prevention of osteoporosis in post-menopausal women, and testing is currently underway to determine whether the drug may also be efficacious in men. It is available in both oral and intravenous forms.

Risedronate
Brand name: Actonel
Risedronate is used to prevent or treat osteoporosis in both men and women, and is also used in the treatment of Paget's disease. It should be taken with a full glass of water, to avoid the pill becoming lodged in the throat, where it has been shown to cause possible tissue damage if it is stuck.

Zoledronate
Brand names: Zometa, Zomera, Aclasta, Reclast
Zoledronate is used primarily as a treatment for some types of cancer, which can result in bone fractures or an excess of calcium in the blood. Depending on the condition being treated, dosage can be monthly, yearly, or just one time total. Side effects are generally only experienced after the first dose is administered.

Bisphosphonates are able to effectively treat a wide variety of bone disorders, and can be an invaluable asset in the prevention of osteoporosis during middle age. Because each has a unique set of side effects, it is always important to consult with a doctor to help determine the prescription drug that is right for your unique condition.

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