Drugs for the treatment and prevention of osteoporosis

Alendronic acid+Colecalciferol (Alendronic acid+Cholecalciferol)

Pills

• Pharmacological action

Combined drug. Alendronic acid, being a bisphosphonate, is localized in areas of active bone resorption, under osteoclasts, inhibits the resorption process without directly affecting the formation of new bone tissue. Since resorption and formation of bone tissue are interrelated, formation also decreases, but to a lesser extent than resorption, which leads to an increase in bone mass. During treatment, normal bone tissue is formed, into the matrix of which alendronic acid is embedded, remaining pharmacologically inactive (in therapeutic doses, alendronic acid does not cause osteomalacia).

Cholecalciferol increases intestinal absorption of Ca2+ and phosphates, regulates their excretion by the kidneys, and also regulates the concentration of Ca2+ in plasma, forms bone tissue and its resorption.

• Indications for use

Postmenopausal osteoporosis in women, osteoporosis in men.

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Alendronic acid (Alendronic acid)

Pills

• Pharmacological action

Non-hormonal specific inhibitor of osteoclastic [bone resorption (from the group of aminobiphosphonates - synthetic analogues of pyrophosphate, which binds hydroxyapatite found in bone), suppresses osteoclasts. Stimulates osteogenesis, restores a positive balance between bone resorption and restoration, progressively increases bone mineral density (regulates phosphorus-calcium metabolism), promotes the formation of normal bone tissue with a normal histological structure.

Indications for use

Paget's disease, osteoporosis in postmenopausal women (prevention of bone fractures, including hip and spine), osteoporosis in men, osteoporosis caused by long-term use of GCS

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Ibandronic acid (Ibandronic acid)

Film-coated tablets, concentrate for solution for infusion

• Pharmacological action

Bisphosphonate (nitrogen-containing), inhibitor of osteoclast activity. Does not affect the process of replenishment of the osteoclast pool. The selective effect of ibandronic acid on bone tissue is due to its high affinity for hydroxyapatite, which is part of the mineral matrix of bone.

Inhibits bone resorption and has no direct effect on bone formation. In menopausal women, it reduces the increased rate of bone turnover to the reproductive age level, which leads to an overall progressive increase in bone mass.

In vivo, ibandronic acid prevents bone destruction induced by gonadal blockade, retinoids, tumors and tumor extracts.

• Indications for use

Tablets 2.5 mg: treatment and prevention of postmenopausal osteoporosis in women.

Tablets 150 mg: prevention of fractures in postmenopausal osteoporosis.

Tablets 50 mg: metastatic bone lesions to reduce the risk of hypercalpemia, pathological fractures, pain relief, reducing the need for radiation therapy in pain syndrome and the threat of fractures. Hypercalcemia in malignant neoplasms.

Calcitonin

Nasal spray dosed

• Pharmacological action

The hormone produced by the C-cells of the thyroid gland is an antagonist of the parathyroid hormone and, together with it, participates in the regulation of Ca2+ metabolism in the body. Reduces bone resorption, promotes the transfer of Ca2+ and phosphates from the blood to bone tissue, reduces the activity of osteoclasts and their number, the content of Ca2+ in the blood serum, increases the activity of osteoblasts (short-term). In individuals with slow resorption processes in bones, it only slightly reduces the concentration of Ca2+ in the blood. Having a direct effect on the kidneys, it reduces the tubular reabsorption of Ca2+, Na+ and phosphorus. Suppresses gastric secretion and the exocrine function of the pancreas. The duration of the hypocalcemic effect of a single dose is 6-8 hours.

• Indications for use

Postmenopausal osteoporosis, bone pain associated with osteolysis and/or osteopenia, Paget's disease, neurodystrophic diseases of various etiologies and caused by various predisposing factors, including post-traumatic pain osteoporosis, reflex dystrophy, scapulohumeral syndrome, causalgia, drug-induced neurotrophic disorders.

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Zelectronic acid (Zoledronic acid)

Solution for infusions

• Pharmacological action

Bone resorption inhibitor, belongs to a new class of highly effective bisphosphonates with selective action on bone tissue. Suppresses osteoclast activity, does not have an undesirable effect on the formation, mineralization and mechanical properties of bone tissue. The selective action of bisphosphonates on bone tissue is based on a high affinity for mineralized bone tissue, but the exact molecular mechanism that provides inhibition of osteoclast activity remains unclear.

It also has direct antitumor properties, ensuring effectiveness in bone metastases.

In vitro it has been established that zoledronic acid, by suppressing proliferation and inducing cell apoptosis, has a direct antitumor effect on myeloma and breast cancer cells, reducing the risk of their metastasis.

Inhibition of osteoclastic bone resorption, altering the bone marrow microenvironment, leads to a decrease in tumor cell growth; antiangiogenic and analgesic activity is noted.

Zoledronic acid also inhibits the proliferation of human endothelial cells. In tumor-induced hypercalcemia, it reduces the concentration of Ca2+ in the blood serum.

• Indications for use

Osteolytic, osteosclerotic and mixed bone metastases of solid tumors; osteolytic foci in multiple myeloma (as part of combination therapy).

Hypercalcemia due to malignancy. Postmenopausal osteoporosis (to reduce the risk of hip, vertebral and non-vertebral fractures, to increase bone mineralization).

Prevention of new osteoporotic fractures in men and women with proximal femur fractures. Paget's disease.

Calcium carbonate+Colecalciferol

Chewable tablets

• Pharmacological action

A combination drug whose action is determined by its components. Regulates the exchange of Ca2+ and phosphates, reduces resorption and increases bone density, replenishes the deficiency of Ca2+ and vitamin D3 in the body, enhances the absorption of Ca2+ in the intestine and the reabsorption of phosphates in the kidneys, promotes bone mineralization.

Calcium carbonate - participates in the formation of bone tissue, blood clotting, maintaining stable cardiac activity, and in the implementation of nerve impulse transmission processes.

The use of Ca2+ and vitamin D3 prevents the increase in the production of parathyroid hormone, which is a stimulator of increased bone resorption.

• Indications for use

Treatment and prevention of Ca2+ and vitamin D3 deficiency: osteoporosis - menopausal, senile, "steroid", idiopathic, etc. (prevention and addition to specific treatment), osteomalacia (associated with mineral metabolism disorders in patients over 45 years of age); hypocalcemia (including after diets with refusal to consume milk and dairy products), with increased need - pregnancy and lactation, as well as in children over 12 years of age during the period of intensive growth.

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