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Alendronic acid was first described in and approved for medical use in the United States in Alendronate inhibits osteoclast -mediated bone-resorption. Its inhibition of bone-resorption is dose-dependent and approximately 1, times stronger than the equimolar effect of the first bisphosphonate drug, etidronate. For optimal action, enough calcium and vitamin D are needed in the body in order to promote normal bone development. Hypocalcemia should, therefore, be corrected before starting therapy. Etidronate has the same disadvantage as pyrophosphate in inhibiting mineralization, but all of the potent N -containing bisphosphonates, including alendronate, risedronate, ibandronate, and zoledronate, do not.
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