FPPS inhibitor
Farnesyl pyrophosphate synthase inhibitor
- Mevalonate-pathway block in osteoclasts
- Impaired prenylation disables osteoclasts → ↓ bone resorption
- Suppressed bone turnover → osteonecrosis of the jaw, atypical femoral fractures
- Acute phase reaction with IV dosing
Drugs with this mechanism (4)
- Alendronate — Oral bisphosphonate for osteoporosis; upright dosing to avoid esophagitis.
- Ibandronate — Nitrogen-containing bisphosphonate; monthly oral or quarterly IV.
- Risedronate — Oral bisphosphonate for osteoporosis.
- Zoledronic acid — Potent IV bisphosphonate given yearly for osteoporosis; acute-phase reaction.
Self-check
- Which bone cells are disabled by impaired prenylation?
Osteoclasts. - Which jaw complication can follow suppressed bone turnover?
Osteonecrosis of the jaw.
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