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BIPHOSPHONATES IN THE TREATMENT OF OSTEOPOROSIS AND METABOLIC DISEASES - 01 MAY 2005

TABLE 1

DRUG
TYPE DOSAGE FDA INDICATION COMMENTS
Etidronate (Didronel)
First generation 400 mg for 2 wksevery 3 months Labeled inCanada and Europe Few adverse events
Alendronate (Fosamax) N-containing
2nd generation
10 mg per day
5 mg per day
Treatment and prevention
of  PMO and GIO
Esophagitis/ upper GI events
Tiludronate (Skelid) S-containing 40 mg per day Treatment of Paget's disease No effect on fracture risk
Risedronate (Actonel) N-containing
2nd generation
5 mg per day Labeling is pending GI side effects similar to placebo
Pamidronate (Aredia) N-containing
2nd generation
40 to 80 mg IV
every 4 months
Hypercalcemia of malignancy
Not labeled for treatment of   osteoporosis therapy
Some systemic effects with IV; none with oral therapy
Ibandronate 2nd generation   1 mg IVevery 3 months Not labeled by FDA;
still in phase III trials
Well tolerated

FDA = U.S. Food and Drug Administration; PMO = postmenopausal osteoporosis;
GIO = glucocorticoid-induced osteoporosis; GI = gastrointestinal; IV = intravenous.