You take most bisphosphonates by mouth—every day, once or
twice a week, or even once a month. Zoledronic acid is given intravenously (IV),
usually only once each year. One form of ibandronate is also given
intravenously, usually every 3 months.
Bisphosphonates are antiresorptive
medicines, which means they slow or stop the natural process that dissolves
bone tissue, resulting in maintained or increased bone density and
strength. This may prevent the development of
osteoporosis. If osteoporosis already has developed, slowing the rate of bone
thinning reduces the risk of broken bones.
Bisphosphonates may be
taken by men or women.
Bisphosphonates are commonly used
for the prevention and treatment of
osteopenia and osteoporosis.
Bisphosphonates are also used to treat other bone diseases such as
Studies show that bisphosphonates
increase bone thickness and may lower the risk of fractures.1
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
or other emergency services right away if you have:
Call your doctor if you are taking bisphosphonates by mouth and you have:
Call your doctor if you are taking intravenous (IV) bisphosphonates and you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
Bisphosphonates are not usually recommended for people with severe kidney disease. Your doctor will test your kidney function before prescribing bisphosphonates, especially if you are considering zoledronic acid (Reclast).
If you are considering a bisphosphonate that is taken by mouth, be sure to tell your doctor if you have ever had serious heartburn or problems with your esophagus (the tube that connects your throat to your stomach).
For the best results
and to reduce the risk of irritation to your
esophagus if you take bisphosphonates by mouth:
Tell your doctor if you notice any new or increasing problems with swallowing. Problems could include feeling pain when you swallow or feeling like you have a lump or sore in your throat.
Tell your doctor if you notice pain in your thigh or groin. Some research suggests that taking bisphosphonates for a long time may slightly increase the risk of breaking the thigh bone.
Serious problems with bone healing, particularly after
dental surgery, have been found in some people who are taking bisphosphonates.2 If you are taking bisphosphonates and need dental surgery,
talk with your doctor.
It is not clear how long you should take bisphosphonates. Experts have suggested that taking bisphosphonates for 3 to 5 years may be enough if you are at low risk of fractures. Talk to your doctor about how long you should take these medicines.
If you are taking bisphosphonates, your doctor may also recommend that you take
calcium and vitamin D supplements. But
calcium supplements may interfere with your body's
ability to absorb bisphosphonates, so take your bisphosphonate and your calcium supplement at least half an hour apart.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Drugs for postmenopausal osteoporosis (2011).
Treatment Guidelines From The Medical Letter, 9(111): 67–74.
Woo S-B, et al. (2006). Systematic review: Bisphosphonates and osteonecrosis of the jaw. Annals of Internal Medicine, 144(10): 753–761.
November 6, 2012
Kathleen Romito, MD - Family Medicine
& Carla J. Herman, MD, MPH - Geriatric Medicine
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