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Bisphosphonates are a class of drugs that lower calcium levels in the blood and can slow down bone loss that results from cancer or other causes.
Bisphosphonates are used to slow down the loss of bone that results from multiple myeloma or from breast cancer that has spread, or metastasized, to the bones. These cancers cause bone to dissolve, in a process called resorption. This results in bone weakness and fractures. Bisphosphonates can prevent the holes that form in the bones from multiple myeloma. They can ease bone pain caused by cancer. They also help to prevent bone fractures and compression of the spinal cord, as well as the high calcium levels in the blood (hypercalcemia) caused by bone loss. Hypercalcemia can cause kidney failure and death. Bisphosphonates may help prevent breast cancer from spreading to the bones and other organs. Clinical trials are evaluating bisphosphonates for the treatment of bone metastases from other types of cancers.
The most commonly used bisphosphonates are pamidronate disodium (APD; brand name Aredia) and etidronate disodium (EHDP; brand name Didronel). Both drugs are approved by the U.S. Food and Drug Administration. These drugs are classified as antihypercalcemics, meaning that they can lower blood calcium levels. They also are classified as bone resorption inhibitors, meaning that they can prevent bone from dissolving.
Other bisphosphonates include cladronate and alendronate. Cladronate is used less frequently because it is not completely absorbed by the digestive system and can cause stomach upset. Zoledronate and ibandronate are new, much more powerful bisphosphonates that are being evaluated, but are not yet available for routine use.
For cancer treatment, bisphosphonates may be used in conjunction with chemotherapy. Treatment with bisphosphonates may be accompanied by the injection of fluids into a vein (intravenous) so that large amounts of urine are excreted.
Author Info: Margaret Alic Ph.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Cancer, 2002
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