alendronate (Merck & Co.)

Fostolin is a brand name for alendronate (alendronate sodium), an oral nitrogen-containing bisphosphonate small-molecule drug. It acts by inhibiting the enzyme farnesyl pyrophosphate synthase (FPPS) in the mevalonate pathway within osteoclasts. This inhibition prevents the biosynthesis of isoprenoid lipids (such as farnesyl pyrophosphate and geranylgeranyl pyrophosphate) required for the post-translational prenylation of small GTPase signaling proteins. The loss of prenylation leads to the disruption of osteoclast function and survival, ultimately reducing bone resorption and increasing bone mineral density. Fostolin is primarily approved for the treatment and prevention of osteoporosis and other metabolic bone diseases (such as Paget's disease). In clinical research, it has been evaluated in the Phase 4 APART trial conducted by University College Dublin to prevent antiretroviral therapy (ART)-associated bone mineral density loss in treatment-naive adults with HIV-1 infection.

Brand names

FostolinFosamaxBinostoRomaxFosteporOsteomelTevanateBonasol

Other names

alendronate sodiumalendronate sodium trihydratealendronic acidmonosodium alendronate