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Bisphosphonates

Synonyms

Diphosphonates, alendronate, ibandronate, pamidronate, risedronate, tiludronate, zolendronate.

Trade Names

Actonel, Aredia, Bonviva, Fosamax, Skelid, Zometa.

Class and Category

Osteoporosis, calcium metabolism.

Indications

Osteoporosis prevention and treatment in men, women, and among glucocorticoid users; Paget's disease; hypercalcemia of malignancy; multiple myeloma and other osteolytic lesion/ bony metastasizes.

Dosage

Varies by compound, please see entries for selected agents.

Contraindications

As a class, oral agents should be avoided in patients with severe esophageal disease such as achalasia or stricture; hypocalcemia; severe renal dysfunction; or hypersensitivity. Hypovolemia with intravenous agents.

Adverse Reactions

With oral agents-Serious: esophagitis, gastritis; Common: dyspepsia, nausea, chest pain, arthralgias/myalgias.

With intravenous agents-Serious: renal failure, pancytopenia, hypocalcemia, pleurisy; Common: fever/chills,