Training and Learning Material for New Representatives and Knowledge Lovers.

1. Mohammed Zamir Mirza Sr Sales
Manager PharmEvo Pvt Ltd
STRONTIUM RENELATE AND
OSTEOPOROSIS

2. STRONTIUM
RENELATE AND
OSTEOPOROSIS
.

3. .
Bone modeling
and
remodeling
Bone modeling
Child and adolescent
Non-coupling : bone formation and resorption
occur on separate surfaces
Bone remodeling
The replacement of old bone tissue by new bone
tissue in the adult skeleton
Coupling

4. .

5. .
Osteoporosis 
imbalance in bone remodeling
Results in thinning
and eventual
loss of trabecular
connectivity

6. .
Definition of Osteoporosis
Osteoporosis is defined as a skeletal disorder characterized by compromised
bone strength predisposing a person to an increased risk of fracture. Bone
strength primarily reflects the integration of bone density and bone quality.
NIH Consensus Conference
Normal bone Osteoporosis
NIH Consensus Development Panel on Osteoporosis. JAMA 285:785-95, 2001

7. .
OSTEOPOROSIS
Primary osteoporosis
Older persons and women past menopause in which bone loss
is accelerated over that predicted for age and sex.
Secondary osteoporosis
Metabolic bone disease,hyperparathyroidism
Neoplasia,multiple myeloma or metastatic carcinoma
Malnutrition,Drug therapy,with corticosteroids
Prolonged immobilization,Weightlessness with space travel

8. .
PREVENTION
■ Primary prevention
– Should provided all the people as comprehensive measures against other lifestyle-related
diseases
■ Secondary prevention
– Should target people at higher risk of osteoporotic fractures
■ Tertiary prevention
– Should be provided the patients and at frail elderly people using medical or long-term care
insurance

9. .

10. .
BONE FRACTURE AREA
IN OSTEOPOROSIS

11. .
Factors affecting
bone metabolism

12. .
Medical treatment
for osteoporosis

13. .
MODE OF ACTION OF STRONTIUM RENELATE

14. .
Strontium ranelate is an antiosteoporotic agent which
both increases bone formation and reduces bone resorption,
resulting in a rebalance of bone turnover in favor of bone
formation. This is similar to the effects of choline-stabilized
orthosilicic acid.
MODE OF ACTION OF STRONTIUM RENELATE

15. .
MODE OF ACTION OF STRONTIUM RENELATE
Pharmacokinetic data
Bioavailability 25% (range 19–27%)
Protein binding 25% for plasma protein and high affinity for
bone tissue
Metabolism As a divalent cation, strontium is not
metabolised. Does not inhibit cytochrome
P450 enzymes
Elimination half-life 60 hours
Excretion Renal and gastrointestinal. Plasma clearance
is about 12 ml/min (CV 22%) and renal
clearance about 7 ml/min (CV 28%)

16. .
effect of Strontium Renelate on bmd
.
NEJM 2004;350:459-468

17. .
adverse events of Strontium
Renelate
.
Gastritis 3.6 5.5 0.066
Gastric ulcer 1.0 1.1 NS
Esophagitis 0.8 0.6 NS
Symptoms (%)
Diarrhea 6.1 3.6 0.019
p
Placebo
Onita

18. .
administration of Strontium
Renelate
.
.
•2g of Strontium Renelate
• mix with a glass of water and drink immediately.
•Taken before bedtime or 2-h before/after the meals

19. .
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