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Bisphosphonates

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Bisphosphonates are stable analogues of pyrophosphate which bind to, and stabilise, bone by inhibiting osteoclastic activity. Bisphosphonates may also directly stimulate formation of bone by osteoblasts (1).

The main indications for bisphosphonates are:

  • Paget's disease of bone
  • hypercalcaemia of malignancy
  • osteoporosis

Bisphosphonates are poorly absorbed after oral ingestion. Further impairment to absorption is caused by food, drinks and drugs containing magnesium, calcium, iron or aluminium salts.

A proportion of bisphosphonate that are absorbed is taken up by, and incorporated into, bone while the remaining fraction is excreted unchanged by the kidneys. Bisphosphonates that have been taken up and incorporated into the skeleton are then only released when the bone is resorbed during turnover.

The oral bisphosphonate medicines prescribed in the UK are:

  • alendronate
  • sodium clodronate
  • disodium etidronate
  • ibandronate
  • risedronate sodium
  • disodium tiludronate

The intravenous/injected bisphosphonates prescribed in the UK are:

  • sodium clodronate
  • ibandronate
  • disodium pamidronate
  • zoledronic acid (2)

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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