Clodronic acid

Clodronic acid
Systematic (IUPAC) name

(dichloro-phosphono-methyl)phosphonic acid
Clinical data
AHFS/Drugs.com	International Drug Names
Identifiers
CAS Number	10596-23-3^Y
ATC code	M05BA02 (WHO)
PubChem	CID 25419
DrugBank	DB00720^Y
ChemSpider	23731^Y
UNII	0813BZ6866^Y
KEGG	D03545^Y
ChEBI	CHEBI:110423^Y
ChEMBL	CHEMBL12318^Y
Chemical data
Formula	CH₄Cl₂O₆P₂
Molar mass	244.892 g/mol
SMILES ClC(Cl)(P(=O)(O)O)P(=O)(O)O
InChI InChI=1S/CH4Cl2O6P2/c2-1(3,10(4,5)6)11(7,8)9/h(H2,4,5,6)(H2,7,8,9)^Y Key:ACSIXWWBWUQEHA-UHFFFAOYSA-N^Y
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Clodronic acid (INN) or clodronate disodium (USAN) is a first generation (non-nitrogenous) bisphosphonate. It is an anti-osteoporotic drug approved for the prevention and treatment of osteoporosis in post-menopausal women and men to reduce vertebral fractures, hyperparathyroidism, hypercalcemia in malignancy, multiple myeloma and fracture related pain because of its potent anti-inflammatory and analgesic effects shown as a reduction in inflammatory markers like IL-1β, IL-6, and TNF-alfa.

An Italian study compared the analgesic effect of clodronic acid versus acetaminophen in rheumatic condition related pain. Study result show a reduction in pain in favor of clodronic acid that provided more analgesia than 3 grams/day of acetaminophen. Clodronate is also used in experimental medicine to selectively deplete macrophages.

Clodronic acid is approved for human use in Canada and Australia, the United Kingdom, where it is marketed as Bonefos, Loron, Clodron and in Italy as Clasteon, Difosfonal, Osteostab and several generics. In other countries is prescribed as a bone resorption inhibitor and antihypercalcemic agent. It is not approved for use in the United States, because it has too many adverse effects.

Use in equine medicine

Clodronic acid is approved for use in horses under the trade name Osphos, for treatment of bone resorptive processes of navicular syndrome. It is given by intramuscular injection at one point in time, with the total dose divided into 2-3 sites on the horse. Clinical effects (e.g. improvement of lameness) after a single treatment can be seen up to 6 months post-treatment.

Adverse reactions and contraindications

Osphos has been shown to have several adverse effects. These include:^[1]

Signs of discomfort, agitation, or colic, usually within 2 hours of treatment.
Head shaking
Lip licking

Drugs for treatment of bone diseases (M05)

Bisphosphonates	Nitrogenous (Alendronic acid ibandronic acid incadronic acid pamidronic acid risedronic acid zoledronic acid) Non-nitrogenous (Etidronic acid clodronic acid tiludronic acid)

Bone morphogenetic proteins	Dibotermin alfa Eptotermin alfa

Other	Resorption inhibitor (Ipriflavone) Aluminium chlorohydrate Dual action bone agent (Strontium ranelate) RANKL inhibitor (Denosumab) Cathepsin K inhibitor (Odanacatib) Calcium Vitamin D

References

↑ U.S. Food and Drug Administration. "FDA Provides Equine Veterinarians with Important Information about TILDREN and OSPHOS for Navicular Syndrome in Horses". http://www.fda.gov/AnimalVeterinary/ResourcesforYou/ucm406581.htm. External link in |website= (help); Missing or empty |url= (help); |access-date= requires |url= (help)

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