Bisphosphonates
PREGNANCY CATEGORY D (PARENTERAL)
PREGNANCY CATEGORY C (ORAL)
Therapeutic Actions
Bisphosphonates inhibit bone resorption, possibly by inhibiting osteoclast activity and promoting osteoclast cell apoptosis; this action leads to decreased release of calcium from bone and decreased serum calcium level.
Indications
Treatment of Paget’s disease of bone (oral)
Treatment of osteoporosis (oral) (postmenopausal and in males)
Treatment of heterotopic ossification (oral)
Treatment of hypercalcemia of malignancy in patients inadequately managed by diet or oral hydration (parenteral)
Treatment of hypercalcemia of malignancy, which persists after adequate hydration has been restored (parenteral)
Prevention of new clinical fractures in patients with low-trauma hip fractures (parenteral)
Contraindications and Cautions
Contraindicated with allergy to bisphosphonates, hypocalcemia, pregnancy, lactation, severe renal impairment.
Use cautiously in the presence of renal impairment, upper GI disease.
Adverse Effects
CNS: Headache, dizziness
CV: Hypertension, chest pain
GI: Nausea, diarrhea, altered taste, metallic taste, abdominal pain, anorexia, esophageal erosion
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