Odanacatib is primarily used in the treatment of osteoporosis, particularly in postmenopausal women. It works by inhibiting cathepsin K, an enzyme involved in the breakdown of bone tissue. By blocking this enzyme, it helps to reduce bone resorption, thereby maintaining bone density and strength. This makes it effective in lowering the risk of fractures and improving overall bone health. It has been studied extensively in clinical trials for its potential to offer a long-term therapeutic option for managing osteoporosis with less frequent dosing compared to other treatments.

Additionally, it has been investigated for efficacy and safety in patients with cancer that has metastasized to the bone, to help slow bone destruction and reduce related complications.