Which medications in the drug class Bisphosphonate Derivatives are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Updated: Jun 14, 2018
  • Author: Segun Toyin Dawodu, JD, MD, MS, MBA, LLM, FAAPMR, FAANEM; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Bisphosphonate Derivatives

These agents are analogs of pyrophosphate. They act by binding to hydroxyapatite in bone-matrix, thereby inhibiting the dissolution of crystals. They prevent osteoclast attachment to the bone matrix and osteoclast recruitment and viability.

Etidronate disodium

Etidronate inhibits normal and abnormal bone resorption. It appears to inhibit bone resorption without inhibiting bone formation and mineralization.

Alendronate (Fosamax, Binosto)

Alendronate inhibits bone resorption via actions on osteoclasts or osteoclast precursors. It is used to treat osteoporosis in both men and women and it may reduce bone resorption and incidence of fracture at spine, hip, and wrist by approximately 50%. Alendronate should be taken with a large glass of water, at least 30 min before eating and drinking, to maximize absorption. Because of possible esophageal irritation, patients must remain upright after taking the medication. Since it is renally excreted, it is not recommended in patients with moderate-to-severe renal insufficiency (ie, CrCl < 30 mL/min or CrCl >3.0 mg/dL), thus its use in perirenal transplantation is limited.

Ibandronate (Boniva)

Ibandronate inhibits osteoclast-mediated bone resorption. In postmenopausal women, it reduces bone turnover rate, leading to a net gain in bone mass.


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