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Drug treatment of osteoporosis

9 articles

Alendronic acid

Alendronic acid (alendronate, Fosamax) is an oral amino-bisphosphonate inhibiting farnesyl pyrophosphate synthase, used for osteoporosis, glucocorticoid-induced osteoporosis, and Paget's disease; 70 mg weekly dosing, FDA-approved 1995.

Alfacalcidol

Alfacalcidol (1α-hydroxycholecalciferol) is a synthetic vitamin D3 analog and calcitriol prodrug that needs no kidney activation, used for chronic kidney disease bone disease, secondary hyperparathyroidism, hypoparathyroidism, and osteoporosis.

Bisphosphonate

Bisphosphonates (diphosphonates) are P–C–P bone-seeking drugs inhibiting osteoclasts; first-line for osteoporosis, Paget's disease, and metastatic bone disease. Key agents: alendronate, risedronate, zoledronate; first clinical use etidronate, 1968.

Clodronate

Clodronate, also known as clodronic acid, is a first-generation bisphosphonate drug that inhibits bone resorption, used since the 1970s for osteoporosis, Paget's disease, and bone metastases.

Denosumab

Denosumab (Prolia, Xgeva) is a human IgG2 monoclonal antibody against RANKL that inhibits osteoclasts; FDA-approved 2010 for osteoporosis and bone metastases, with a 2024 boxed warning for severe hypocalcemia in advanced kidney disease.

Minodronic acid

Minodronic acid (minodronate, YM-529; Recalbon/Bonoteo) is a third-generation nitrogen-containing bisphosphonate for osteoporosis, developed in Japan, approved January 2009, dosed 1 mg daily or 50 mg every 4 weeks, use limited to Japan.

Pamidronic acid

Pamidronic acid, also called pamidronate, is a nitrogen-containing bisphosphonate drug that binds to bone and inhibits osteoclasts, given intravenously for hypercalcemia of malignancy, Paget's disease, and bone metastases.

Raloxifene

Raloxifene (Evista), a benzothiophene SERM taken orally at 60 mg daily, treats and prevents postmenopausal osteoporosis and reduces invasive breast cancer risk; unlike tamoxifen it spares the endometrium but raises venous thromboembolism risk.

Zoledronic acid

Zoledronic acid (zoledronate; Reclast/Aclasta, Zometa) is a nitrogen-containing bisphosphonate given intravenously, 5 mg yearly for osteoporosis and Paget's disease and 4 mg monthly for skeletal complications of malignancy, reducing hip, vertebral, and nonvertebral fractures.