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      There is a lot of confusion re/which drugs are classified as Bisphosphonates.  I found this chart which will clear up questions regarding this family of drugs.  Hope this helps.      Carol          Bisphosphonates:
                 
                  Corrected calcium= serum calcium + 0.8 (4 - serum albumin)
                  Bisphosphonates inhibit bone resorption via actions on osteoclasts or on osteoclast precursors which leads to decreases in the rate of bone resorption and an indirect increase in bone mineral density.
                 
                  alendronate (Fosamax ®):  Postmenopausal osteoporosis prevention: 5 mg orally once daily or treatment: 10 mg orally once daily. Glucocorticoid induced: 5-10 mg orally once daily. Paget's disease: 40 mg orally once daily x 6 months. May cause esophagitis. Alendronate should be taken in the morning with a full glass (eg, 6 to 8 ounces) of plain water at least one-half hour before food, beverages, or other medications. 
                  etidronate (Didronel ®): Hypercalcemia: 7.5 mg/kg IV over 2 hours once daily x 3 days. Paget's disease: 5-10 mg/kg orally once daily x 6 months or 11-20 mg/kg x 3 months. 
                  ibandronate
                  (Boniva ®):  Bisphosphonate. Adults (usual):  Treatment of postmenopausal osteoporosis: 2.5 mg orally once day or 150 mg once a month.
                  Prevention of postmenopausal osteoporosis:  2.5 mg orally once daily. 150 mg once a month may be considered.

                  Supplied:  2.5 mg  tablet (once-daily formulation),  150 mg tablet - (once-monthly formulation). 
                  pamidronate (Aredia ®):  Hypercalcemia: 60-90mg IV single dose.  Wait at least 7 days before considering retreatment.  Usual recommendation for moderate hypercalcemia (corrected serum calcium of 12 to 13.5 milligrams/dL) is 60 to 90 milligrams.  The 90 mg dose is recommended for severe hypercalcemia (corrected calcium greater than 13.5 milligrams/dL) 
                  risedronate (Actonel ®):  Paget's disease: 30 mg orally once daily x 2 months. May cause esophagitis. (100 times more potent than pamidronate or alendronate). Should be  taken on an empty stomach in an upright position with at least 6 ounces of plain water. The upright position and empty stomach should be maintained for at least 30 minutes to minimize gastrointestinal adverse events and increase absorption.   [Supplied: 30mg tablet] 
                  tiludronate (Skelid ®): Paget's disease: 400mg orally once daily x 3 months.  Each dose should be taken with 6 to 8 ounces of  water. Tiludronate should not be taken within 2 hours of food or other medications. 
                  Zoledronic acid (Zometa®) Adult (usual): Hypercalcemia of malignancy: 4 mg IV given as a single dose infusion over no less than 15 min; may repeat after a minimum of 7 days if serum calcium does not return to normal or remain normal after initial treatment.  Multiple myeloma/metastatic bone lesions from solid tumors: 4 mg IV infused over 15 min every 3-4 weeks; administer with an oral calcium supplement of 500 mg and a multiple vitamin containing 400 International Units of vitamin D.  Paget's disease: 100-400 mcg as a single infusion infused over 1 hr.    Vigorous saline hydration alone may be sufficient to treat mild, asymptomatic hypercalcemia. The maximum recommended dose of Zometa in hypercalcemia of malignancy (albumin-corrected serum calcium * >/=12 mg/dL [3.0 mmol/L]) is 4 mg.   The 4-mg dose must be given as a single-dose intravenous infusion over no less than 15 minutes.  Patients should be adequately rehydrated prior to administration of Zometa.   Renal function must be carefully monitored in all patients receiving Zometa and possible deterioration in renal function must be assessed prior to retreatment with Zometa. 
                  Osteoporosis - other:
                 
                  Raloxifene (Evista®) Adult (usual): Osteoporosis prevention: 60 mg orally qd.   Osteoporosis treatment: 60 mg orally qd.  
                  Teriparatide (Forteo®) Adult (usual):  Osteoporosis: 20 mcg SC once daily.   Administration:  give as SC injection into the thigh or abdominal wall.  Initial injection should occur where the patient is able to sit or lie down in case symptoms of orthostatic hypertension occur.   Use for more than 2 years is not recommended.  Teriparatide is the biologically active N-terminal region of the human parathyroid hormone.

                  Supplied: Solution for injection: 250 mcg/ml (3 ml).  Prefilled syringe, delivers teriparatide 20 mcg/dose.  Refrigerated.  
            
     

     

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