Some basic information regarding osteoporosis treatment. Bones and some bone related diseases

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2. Ibandronate Sodium
Some Basics
By
Rana Khurram Shahzad
Product Manager

3. Contents
• Bone
• Types of bones
• Functions of bones
• Diseases of bones
• Treatment options
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Bone
Human Skelton

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• Bone is made up of Osseous tissue,
cartilage, dense connective tissue,
epithelium, adipose tissue.
• The entire framework of bones and
cartilages constitute the “Skeletal
System”.

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STRUCTURE OF BONE

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Bone has both Organic and Inorganic
components
Organic part - consists mainly of protein
collagen & specialized cells called
osteoclasts, osteoblasts, and osteocytes
Inorganic part - consists mainly of calcium
phosphate.
Composition of bone

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TYPES OF BONES
There are 270 bones at the time of birth
this total then decreases to 206 bones by
adulthood after some bones fused
together.
Human Skeleton divided in two parts
1. Axial Skeleton
2. Appendicular Skeleton

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LONG BONES
SHORT BONES
FLAT BONES
IRREGULAR BONES
SESAMOID BONES
TYPES OF BONES

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FUNCTIONS OF BONE
• Support
• Protection
• Assists movement
• Mineral storage
• Hematopoiesis

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Types of bone tissue
• Compact bone tissue
(OsseousTissue)
• Spongy bone tissue

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BONE CELLS
Four types of cells:
• Osteogenic cells
• Osteoblasts
• Osteocytes
• Osteoclasts

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Some BONES related
Diseases
1- Arthritis
2- Bursitis
3- Tendonitis
4- Osteoporosis
5- Scoliosis
6- Spine TB
7- Rickets
8- Gout
9- Acromegaly
10- Poliomyelitis
11- Spina Bifida
12- Club foot
13- Bone Cancer(Sarcoma, Myeloma,
Leukemia)

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Osteoporosi
s

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Osteoporosis:
Is a systemic skeletal
disease characterized
by low bone density
and
microarchitectural
deterioration of bone
tissue with a
consequent increase
in bone fragility

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Difference of Normal &
Osteoporotic BONES

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Osteoporosis is 3 time more
common in women then in men,
because women have lower peak
bone mass and hormonal
changes at the time of
menopause

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Approximately 1 in 2 women and 1 in
4 men over age 50 will have an
osteoporosis related fracture in their
remaining lifetime.

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Causes of Osteoporosis
• Being female
• Older age
• Family history of osteoporosis.
• History of broken bones
• Low sex hormones
– Low estrogen levels in women, including
menopause
– Missing periods (amenorrhea)
– Low levels of testosterone in male.

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• Diet
– Low calcium intake
– Low vitamin D intake
– Excessive intake of
protein, sodium and
caffeine
• Inactive lifestyle
• Smoking , Alcohol abuse

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• Certain medications
– steroid, anticonvulsants etc
• Certain diseases
–anorexia nervosa, rheumatoid
arthritis, gastrointestinal diseases and
others

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Diagnosis

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Diagnosis
BMD test is done to diagnose and
predict fracture risk and to monitor
therapy.
T score Category
> -1 Normal
< -1 to > 2.5 Osteopenia
<-2.5 Osteoporosis
<-2.5 with
fragility fracture
Established/severe
osteoporosis

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Treatment Options
 Bisphosphonates.
 Strontium ranelate.
 Selective oestrogen receptor modulators (SERMs)
 Parathyroid hormone (teriparatide)
 Calcium and vitamin D supplements.
 Hormone replacement therapy (HRT)
 Testosterone treatment

29. BISPHOSPHONATE
Bisphosphonates are
a class of drugs that
prevent the loss
of bone mass, used to
treat osteoporosis and
similar diseases. They are
the most commonly
prescribed drugs used to
treat osteoporosis

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• Indications for bisphosphonates include such
conditions
1. Postmenopausal
2. Glucocorticoid-induced osteoporosis,
3. Paget’s disease,
4. Osteolytic and osteoblastic bone metastases,
5. Fibrous dysplasia,
6. Heterotopic ossification,
7. Myositis ossificans.
8. Other bisphosphonates, medronate (R1, R2 = H) and
oxidronate (R1 = H, R2 = OH) are mixed with radioactive
technetium and are injected for imaging bone and detecting
bone disease

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NON-NITROGENOUS
Olpadronate
NITROGENOUS
Tiludronate
Clodronate
Etidronate
Alendronate
Neridronate
Pamidronate
Risedronate
Ibandronate

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(Ibandronate Sodium) inhibits
osteoclast activity and reduces
bone resorption and turnover
Mechanism of Action

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Pharmacokinetics
 Absorption
The absorption of oral ibandronate occurs in
the upper gastrointestinal tract.
 Distribution
After absorption, ibandronate rapidly binds to
bone. In vitro protein binding in human
serum was 99.5% to 90.9%.

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 Elimination
The portion of ibandronate that is not removed from
the circulation via bone absorption is eliminated
unchanged
by the kidney (approximately 50% to 60% of the
absorbed dose). Unabsorbed ibandronate is eliminated
unchanged in the feces.
 Metabolism
Ibandronate does not undergo hepatic
metabolism and does not inhibit the
hepatic cytochrome P450 system.

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(Ibandronate Sodium) is a
bisphosphonate indicated for the
treatment and prevention of
osteoporosis.
Indications

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DOSAGE AND ADMINISTRATION
The dose of Ibandronate is 150 mg ONE
tablet taken once monthly on the same
date each month.

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Important Administration Instructions
• Take Ibandronate at least 60 minutes before
the first food or drink (other than water) of the
day or before taking any oral medication or
supplementation including calcium, antacids,
or vitamins to maximize absorption and clinical
benefit.
• Avoid the use of water with supplements
including mineral water because they may
have a higher concentration of calcium.

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• Swallow Ibandronate tablet whole with
a full glass of plain water while
standing or sitting in an upright position
to reduce the potential for esophageal
irritation.
• Avoid lying down for 60 minutes after
taking Ibandronate.
• Do not eat, drink anything except plain
water, or take other medications for at
least 60 minutes after taking
Ibandronate.

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