<unk> s are used to treat osteoporosis, osteitis deformans (Paget's disease of the bone), bone metastasis (with or without hypercalcemia), multiple myeloma, and other conditions involving fragile, breakable bone. In osteoporosis and Paget's, the most popular first-line<unk>  drugs are alendronate and risedronate. If these are ineffective or if the person develops digestive tract problems, intravenous pamidronate may be used. Strontium ranelate or teriparatide are used for refractory disease. The use of strontium ranelate is restricted because of increased risk of venous thromboembolism, pulmonary embolism and serious cardiovascular disorders, including myocardial infarction. In postmenopausal women, the selective estrogen receptor modulator raloxifene is occasionally administered instead of<unk> s.<unk> s are beneficial in reducing the risk of vertebral fracture in steroid induced osteoporosis. Post-menopausal osteoporosis<unk> s are recommended as a first line treatments for post-menopausal osteoporosis. Long-term treatment with<unk> s produces anti-fracture and bone mineral density effects that persist for 3–5 years after an initial 3–5 years of treatment. The<unk>  alendronate reduces the risk of hip, vertebral, and wrist fractures by 35-39%; zoledronate reduces the risk of hip fractures by 38% and of vertebral fractures by 62%. Risedronate has also been shown to reduce the risk of hip fractures. After five years of medications by mouth or three years of intravenous medication among those at low risk,<unk>  treatment can be stopped. In those at higher risk ten years of medication by mouth or six years of intravenous treatment may be used. Cancer<unk> s reduce the risk of fracture and bone pain in people with breast, lung, and other metastatic cancers as well as in people with multiple myeloma. In breast cancer there is mixed evidence regarding whether<unk> s improve survival. A 2017 Cochrane review found that for people with early breast cancer,<unk>  treatment may reduce the risk of the cancer spreading to the person's bone, however, for people who had advanced breast cancer<unk>  treatment did not appear to reduce the risk of the cancer spreading to the bone. Side effects associated with<unk>  treatment for people with breast cancer are mild and rare.<unk> s can also reduce mortality in those with multiple myeloma and prostate cancer. Other Evidence suggests that the use of<unk> s would be useful in the treatment of complex regional pain syndrome, a neuro-immune problem with high MPQ scores, low treatment efficacy and symptoms which can include regional osteoporosis. In 2009<unk> s were "among the only class of medications that has survived placebo-controlled studies showing statistically significant improvement (in CRPS) with therapy."<unk> s have been used to reduce fracture rates in children with the disease osteogenesis imperfecta and to treat otosclerosis by minimizing bone loss. Other<unk> s, including medronate (R1=H, R2=H) and oxidronate (R1=H, R2=OH), are mixed with radioactive technetium and injected, as a way to image bone and detect bone disease.
Bisphosphonate
Phosphate binder
Pamidronic acid
Etidronic acid
Sulfonylurea
Allopurinol
Risedronic acid
Alendronic acid