Pamidronate / Zoledronate
Approved, for something elseHeight measured in peopleBy injectionSmall molecule
Two bone drugs dripped into a vein, which shut down the cells that dissolve bone. Both are approved for adults. Neither is approved for children, and the one trial in children with brittle bone disease raised their bone density without changing that.
Nitrogen-containing bisphosphonates, both given by infusion. They bind bone mineral, are taken up by the osteoclast during resorption and block the mevalonate pathway inside it, so the small GTPases the resorbing cytoskeleton depends on are never prenylated. Pamidronate is approved for hypercalcaemia of malignancy, Paget's disease of bone and osteolytic lesions, with safety and effectiveness in children not established. Zoledronate, as Reclast, is approved for osteoporosis and Paget's disease, and that label states it is not indicated for use in children — which its one-year trial in 152 children aged 1 to 17 with severe osteogenesis imperfecta did not change: density rose, and the label records that changes in density did not necessarily correlate with fracture risk or with chronic bone pain.
Risks. Both record kidney damage up to kidney failure, death of jaw bone, unusual thigh fractures and blood calcium low enough to cause muscle spasm, and a kidney blood test is required before each treatment. Given in excessive amounts through childhood, pamidronate has shut the bone-clearing cells down so completely that the skeleton came to look like osteopetrosis, the disease in which bone is never resorbed, and the same has now been shown for repeated high doses of zoledronate.
On this page
- At the growth plate, members only
- Risks and side effects, members only
The rest of this page is for members
What has been measured, in whom, with every source, and what it does to the rest of you. And every article in the library.
Join for $11.99Lifetime · 3 of 10 founding spots left
Tax is added at checkout (VAT/GST where it applies).
Renews every month at the current price plus tax until you cancel. Cancel from your account before the next monthly charge to stop it.
Card purchases are sold and charged by Link (Stripe) under Link's terms and refund policy.
Already a member? Sign in
Educational content, not medical advice. Nothing here is a recommendation to take or stop taking anything — talk to a doctor about your own situation.