Not available in the U.S.
Clodronate
BONEFOS
What it isFirst-generation non-nitrogen bisphosphonate; hypercalcemia and bone metastases.
Why this oneIt is metabolized to a toxic ATP analogue rather than blocking the mevalonate pathway, a different mechanism from the modern agents.
What limits itWeaker than the nitrogen-containing bisphosphonates. Not US-approved.
FDA-approved for
- hypercalcemia / bone metastases (non-US)
Off-label
- hypercalcemia of malignancy
- bone metastases (approved in Europe and Canada)
NO BOXED WARNINGS
Principal riskWeaker than the nitrogen-containing bisphosphonates