Bisphosphonates in clinical practice

  • Bilal Ahmad Rather Department of Internal Medicine SKIMS
  • Sajad A Bhat Department of Internal Medicine SKIMS
Keywords: Bisphosphonates, Hypercalcemia.


Bisphosphonates are analogues of pyrophosphate where P-C-P forms the core of molecule in place of P-O-P.They suppress resorption of bone while itself getting absorbed to hydroxyapetite of bone. These  are classified into three generations according to modifications in side chain. Bisphosphonates are widely used for osteoporosis, hypercalcemia of malignancy, Paget's disease of bone etc.


1.Ploske GL, Goa KL. Clodronate. A review of its pharmalogical properties and therapeutic efficacy in resorptive bone disease. Drugs. 1994 jun; 47(6): 945-82.
2.Schnitzer T, Bone HG, Crepaldi G, etal: Therapeutic evidence of alendronate 70 mg once weekly and alendronate 10 mg daily in the treatment of osteoporosis. Aging 12:1-12,2000.
3.Harris ST, Watts NB, Genant HK, etal: Effects of risedronate treatment on vertebral and non vertebral fractures in women with post menopausal osteoporosis.: a randomized controlled trial. Vertebral efficiency Risedronate Therapy. (VERT) study group. JAMA 282:1344,1999.
4.Mc Clung MR, Geusens P, Miller PD, etal: Effect of Risedronate on the risk of hip fractures in elderly women. N Eng J Med 344: 333-340,2001.
5.Delany M, Harwitz S, Shew J, etal: Bone density changes with once weekly Risedronate in post menopausal women . J Clin Densitom 6:45-50,2003.
6.B. Miller PD, Brown JP, Sirs ES: A randomized double blind trial of risedronate and ibandronate in the treatment of pagets disease. Am J Med 106:513-520,1999.
7.Reginster JY, Adami S, Lakatos P, etal: Efficacy and tolerability of once monthly oral ibandronate in post menopausal osteoporosis: 2 year results from the MOBILE study. ANN Rheum Dis 65:654-661,2006.
8.Ebetino FH,et al.The relationship between the chemistry and biological activity of the bisphosphonates. Bone,2011,49:20-33.
9.Black DM, Delmas PD, Eastell R,etal. Once yearly zolendronic acid for treatment of post menopausal osteoporosis.N Eng Med 356:1809-1822,2007.
10.Bisphosphonates and cardiovascular risk in elderly patients with previous cardiovascular disease: a population based nested case-control study in Itlay. Ursula Kirch meyer,chiara sorge, jenet sultane etal. Therapeutic advances in drug safety 2019, vol. 10:1-14.
How to Cite
Rather BA, Bhat SA. Bisphosphonates in clinical practice. jms [Internet]. 2019May28 [cited 2019Jul.19];22(1):93-5. Available from:
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