Known brand names include Fosamax, Binosto, and Fosamax Plus D.
A bisphosphonate pill that slows bone breakdown to treat and prevent osteoporosis and treat Paget's disease of bone. It must be taken first thing in the morning with a full glass of plain water, at least 30 minutes before food, drink, or other medicines, while staying upright, to protect the esophagus.
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The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
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No specific antidote. Give milk or antacids to bind the drug, do not induce vomiting, and keep the patient fully upright. Watch for hypocalcemia, hypophosphatemia, and upper GI injury. Dialysis does not help.
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Doses come from the FDA label. Study tool, not for clinical decisions.
Not recommended with creatinine clearance below 35 mL/min; no change needed at 35 to 60 mL/min.
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A bisphosphonate, a pyrophosphate analog that binds bone hydroxyapatite and concentrates under osteoclasts, inhibiting osteoclast-mediated resorption without blocking osteoclast recruitment or attachment. Bone turnover falls while formation exceeds resorption at remodeling sites, so bone mass rises. Drug buried in bone matrix is inactive. Oral bioavailability is under 1% even fasting, and food, coffee, or orange juice lowers it further; unabsorbed drug is excreted and absorbed drug goes to bone or urine.