Preparations for the treatment and prevention of osteoporosis

Alendronic acid + Colecalciferol (alendronic acid + cholecalciferol)

Pills

• pharmachologic effect

Combined drug. Alendronic acid, being a bisphosphonate, is localized in areas of active bone resorption, under osteoclasts, inhibits the process of resorption, 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, in the matrix of which alendronic acid is incorporated, remaining pharmacologically inactive (in therapeutic doses alendronic acid does not cause osteomalacia).

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

• Indications for use

Osteoporosis in postmenopause in women, osteoporosis in men.

[1], [2], [3]

Alendronic acid (alendronic acid)

Pills

• pharmachologic effect

Non-hormonal specific inhibitor of osteoclastic [bone resorption (from the group of aminobiphosphonates - synthetic analogues of pyrophosphate, binding hydroxyapatite, located in the bone), suppresses osteoclasts. Stimulates osteogenesis, restores a positive balance between resorption and bone 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

[4], [5], [6], [7], [8]

Ibandronic acid (Ibandronic acid)

Coated tablets, concentrate for the preparation of a solution for infusions

• pharmachologic effect

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

It inhibits bone resorption and does not directly affect the formation of bone tissue. In women in menopause reduces the increased rate of bone tissue renewal to the value of reproductive age. Which leads to a general progressive increase in bone mass.

In vivo ibandronic acid prevents bone destruction caused by blockade of the function of the gonads, retinoids, tumors and extracts of tumors.

• Indications for use

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

150 mg tablets: prevention of fractures in postmenopausal osteoporosis.

Tablets 50 mg: metastatic bone damage in order to reduce the risk of hypercalcemia. Pathological fractures, reducing pain, reducing the need for radiotherapy in case of pain and the threat of fractures. Hypercalcemia in malignant neoplasms.

Calcitonin (Calcitonin)

Nasal dosing spray

• pharmachologic effect

The hormone produced by the S-cells of the chitovil gland is the antagonist of the parathyroid hormone and, together with it, participates in the regulation of the exchange of Ca2 + in the body. It reduces the resorption of bone tissue, promotes the transition of Ca2 + and phosphates from the blood to bone tissue, reduces the activity of osteoclasts and their quantity, the content of Ca2 + in the serum, increases the activity of osteoblasts (short-term). In individuals with slow resorption processes in the bones only slightly reduces the concentration of Ca2 + in the blood. By direct action on the kidneys, reduces tubular reabsorption of Ca2 +, Na + and phosphorus. Suppresses gastric secretion and exocrine pancreatic function. The duration of the hypocalcemic action 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, incl. Posttraumatic pain osteoporosis, reflex degeneration, humerus syndrome, causalgia, drug neurotrophic disorders.

[9], [10], [11], [12], [13]

Zelectronic acid (Zoledronic acid)

Solution for infusions

• pharmachologic effect

Inhibitor of bone resorption, belongs to a new class of highly effective bisphosphonates, which have a selective effect on bone tissue. Suppresses the activity of osteoclasts, does not have undesirable effects on the formation, mineralization and mechanical properties of bone tissue. Selective action of bisphosphonates on bone tissue is based on a high affinity for mineralized bone tissue, but the exact molecular mechanism providing inhibition of osteoclast activity is still unclear.

It also has direct antitumor properties that provide efficacy in bone metastases.

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

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

Zoledronic acid also suppresses the proliferation of human endothelial cells. With hypercalcemia caused by the tumor, reduces the concentration of Ca2 + in the serum.

• Indications for use

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

Hypercalcemia caused by a malignant tumor. Postmenopausal osteoporosis (to reduce the risk of fractures of the femur, vertebrae and extravertebral fractures, to increase bone mineralization).

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

Calcium carbonate + Colecalciferol (Calcium carbonate + Colecalciferol)

Chewing tablets

• pharmachologic effect

Combined drug, the effect of which is due to its constituent components. It regulates the metabolism of Ca2 + and phosphates, reduces resorption and increases the density of bone tissue, replenishes the lack of Ca2 + and vitamin D3 in the body, increases absorption of Ca2 + in the intestine and reabsorption of phosphates in the kidneys, promotes the mineralization of bones.

Calcium carbonate - is involved in the formation of bone tissue, blood clotting, in the maintenance of stable cardiac activity, in the process of transmission of nerve impulses.

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 deficiency of Ca2 + and vitamin D3: osteoporosis - menopausal, senile, steroidal, idiopathic, etc. (prevention and addition to specific treatment), osteomalacia (associated with a violation of mineral metabolism in patients older than 45 years); hypocalcemia (including after compliance with diets with refusal to accept milk and dairy products), with increased need for pregnancy and lactation, as well as for children over 12 years of age during a period of intensive growth.

[14]