Etidronic acid
Etidronic acid Uses, Dosage, Side Effects, Food Interaction and all others data.
Etidronic acid is a first generation bisphosphonate similar to clodronic acid and tiludronic acid. These drugs were developed to mimic the action of pyrophosphate, a regulator of calcification and decalcification. Etidronate’s use has decreased over the years in favor of the third generation, nitrogen containing bisphosphonate zoledronic acid, ibandronic acid, minodronic acid, and risedronic acid.
Etidronic acid was granted FDA approval on 1 September 1977.
Etidronic acid is a first generation bisphosphonate that inhibits the action of osteoclasts, preventing bone resporption. It has a wide therapeutic index as overdoses are not associated with severe toxicity and a long duration of action as it slowly releases from the bone. Patients should be counselled regarding the risk of upper gastrointestinal adverse reactions.
| Trade Name | Etidronic acid |
| Generic | Etidronic acid |
| Etidronic acid Other Names | Acetodiphosphonic acid, acide étidronique, ácido etidrónico, acidum etidronicum, EHDP, Etidronate, Etidronic acid, Etidronsäure, HEDP, Hydroxyethanediphosphonic acid, Oxyethylidenediphosphonic acid |
| Type | |
| Formula | C2H8O7P2 |
| Weight | Average: 206.0282 Monoisotopic: 205.974525634 |
| Groups | Approved |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Etidronic acid is a bisphosphonate drug that prevents osteoclastic bone resorption; used for the prevention and treatment of osteoporosis.
Etidronate is indicated to treat Paget's disease of bone, as well as the treatment and prevention of heterotropic ossification after total hip replacement of spinal cord injury.
Etidronic acid is also used to associated treatment for these conditions: Heterotopic Ossification (HO), Paget's Disease of Bone
How Etidronic acid works
Bisphosphonates are taken into the bone where they bind to hydroxyapatite. Bone resorption by osteoclasts causes local acidification, releasing the bisphosphonate, which is taken into the osteoclast by fluid-phase endocytosis. Endocytic vesicles become acidified, releasing bisphosphonates into the cytosol of osteoclasts where they act.
Osteoclasts mediate resorption of bone. When osteoclasts bind to bone they form podosomes, ring structures of F-actin. Disruption of the podosomes causes osteoclasts to detach from bones, preventing bone resorption.
First generation bisphosphonates closely mimic the structure of pyrophosphate, which can be incorporated into ATP anologues that cannot be hydrolyzed, disrupting all ATP mediated actions of osteoclasts.
Toxicity
Patients experiencing an overdose may present with hypocalcemia, vomiting, parasthesia, and diarrhea. Overdose can be treated with symptomatic and supportive treatment that may include management of electrolyte imbalances and intravenous calcium gluconate.
Food Interaction
- Avoid multivalent ions. Separate administration from multivalent ions by at least two hours.
- Take on an empty stomach.
- Take with a full glass of water.
Volume of Distribution
Etidronic acid has a volume of distribution of 0.3-1.3L/kg.
Elimination Route
Etidronic acid has an oral bioavailability of 1-10%. Further data regarding pharmacokinetics of etidronic acid are not readily available.
Half Life
The half life of etidronate is approximately 1-6 hours.
Clearance
Etidronic acid has a renal clearance of 0.09L/kg/h.
Elimination Route
Absorbed etidronic acid is eliminated in the urine, while the unabsorbed drug is eliminated in the feces.
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