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

Trade Names

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

Class and Category

Osteoporosis, calcium metabolism.


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.


Varies by compound, please see entries for selected agents.


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,