Bisphosphonates

The bisphosphonates are stable analogues of pyrophosphate, a naturally occurring regulator of bone metabolism. They have a high affinity for calcium ions, and bind rapidly to hydroxyapatite crystals in mineralized bone. Bisphosphonates are subsequently released and taken up by osteoclasts, interfering with their function and/or inducing their apoptosis (programmed cell death). Nitrogen-containing bisphosphonates (e.g. alendronate, ibandronic acid, pamidronate disodium, zoledronic acid) inhibit the mevalonate pathway vital for normal cellular function (e.g.

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