Bisphosphonates and Ocular Inflammation

Abstract

Bisphosphonates are used to inhibit bone resorption in postmenopausal women and to manage hypercalcemia associated with osteolytic bone cancer, metastases of breast cancer, multiple myeloma, and Paget's disease of bone. Pamidronate disodium can cause uveitis, nonspecific conjunctivitis, episcleritis, or scleritis.^1,2 The drug must be discontinued to resolve the scleritis. Other bisphosphonates available in the United States include alendronate sodium (Fosamax, Merck), risedronate sodium (Actonel, Procter & Gamble), zoledronic acid (Zometa, Novartis), etidronate disodium (Didronel, Procter & Gamble), and tiludronate disodium (Skelid, Sanofi Winthrop). Bisphosphonates not approved by the Food and Drug Administration (FDA) include clodronate disodium (Ostac, Roche, and Bonefos, Aventis Pharma), ibandronate (Roche and GlaxoSmithKline), and olpadronate (Gador Pharmaceuticals). The Physicians' Desk Reference for Ophthalmology ³ does not list ocular inflammation as a potential side effect of the bisphosphonates marketed in the United States.