How Do Bisphosphonate Derivatives Work?

Bisphosphonatederivatives are a class of drugs used to prevent the loss ofbone densityto treatpostmenopausal骨质疏松症(aconditioninwhich bones become thin and weak and break easily), osteoporosis in men,glucocorticoid-induced osteoporosis (a type ofcorticosteroidmedicationthat may cause osteoporosis), and Paget’sdisease(a condition in which bones become soft and weak and may be deformed, painful, or easily broken) and to treat high levels ofcalciumin thebloodthat may be caused by certain types ofcancer.

Bonetissueundergoes constant remodeling and is kept inbalance(homeostasis) by osteoblasts (cells that form new bone) and osteoclasts (responsible for boneresorption) activity. Bisphosphonates inhibit the digestion of bone by encouraging osteoclasts to undergoapoptosis(celldeath), thereby slowing down bone loss. Bisphosphonate derivatives help reduce theincidenceof fractures (hip and vertebral and nonvertebral osteoporosis-related fractures) and are also used with cancerchemotherapyto treat bone problems that may occur withmultiple myeloma(cancer that begins in theplasma细胞)和其他类型的癌症(如breast和肺)传播to the bones.

Bisphosphonate derivatives are administered orally as atablet, a delayed-release tablet, an effervescent tablet (dissolves inwater), and a solution (liquid) and intravenously (into avein).

Bisphosphonate derivatives work in the following ways:

• Work by slowing down the bone loss to help maintain strong bones and reduce the risk of bone fractures.
• Increase bone density (thickness).
• In addition, they help in lowering high blood calcium levels by reducing the amount of calcium released from bones into the blood.

Bisphosphonate derivatives are used in conditions such as:

• Postmenopausal osteoporosis
• Osteoporosis in men
• Glucocorticoid-induced osteoporosis
• Paget’s disease
• Heterotopicossification(growth of bone tissue in an area of the body other than theskeleton) in patients with:
  • Total hip replacementsurgery(surgery to replace the hipjointwith an artificial joint)
  • Spinal cord injury
• Hypercalcemiaofmalignancy(high blood calcium levels):
  • Multiplemyeloma(cancer that forms in a type of white blood cells called plasma cells)
  • Bone metastases from solid tumors

Some of the common side effects include:

• 腹泻
• Nausea
• Vomiting
• Myalgia(musclepain)
• Stomachupset
• Weakness
• Abdominal pain
• Headache
• Tiredness
• Constipation
• Loss of appetite
• Heartburn
• Mouthsores
• Bloating
• Flatulence(gas)
• Legcramps
• Back pain
• Arthralgia(pain in one or more joints)

Other rare side effects include:

• Chest pain
• Dizziness(feeling faint, weak, or unsteady)
• Flu-like symptoms (such asfever,chills, muscle/joint aches)
• Weight loss
• Numbness or heavy feeling in thejaw
• 就很难tybreathing
• Hypocalcemia(low blood calcium level)
• Urinary tract infection
• Hypertension(high blood pressure)
• Asthenia(abnormalphysical weakness or lack of energy)
• Severe muscle spasms
• Irregular heartbeat
• Insomnia(trouble falling and/or staying asleep)
• Swelling of the face,throat,tongue,lips, eyes, hands,feet, ankles, or lower legs

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with yourdoctororpharmacistto make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Genericand brand names of bisphosphonate derivatives include:

• Actonel
• Actonel with Calcium
• Alendronate
• Atelvia
• Binosto
• Boniva
• Didronel
• Etidronate
• Fosamax
• Fosamax plus D
• Ibandronate
• Reclast
• Risedronate
• Skelid
• Zoledronic acid
• Zometa