Nitrogen-containing bisphosphonates are used widely for themanagement of metastatic cancer in bone (intravenous zoledronicacid or pamidronate), for the prevention and treatment of osteoporosis(oral alendronate, risedronate, and ibandronate and intravenousibandronate), for the treatment of Paget's disease of bone (intravenouspamidronate and oral alendronate and risedronate), and for theshort-term management of acute hypercalcemia (intravenous zoledronicacid and pamidronate). The nitrogen moiety attached to the sidechain of the middle carbon of the phosphoruscarbonphosphorusbisphosphonate backbone renders these drugs much more potentas inhibitors of bone resorption than the bisphosphonates thatdo not contain nitrogen (etidronate and clodronate). . . . [Full Text of this Article]
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Dr. Bilezikian is a professor of medicine and pharmacology at the College of Physicians and Surgeons, Columbia University, New York.
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