Bisphosphonates

Several medicines make up the class of bisphosphonates. They are the most common type of medicine used to help prevent and treat bone loss.

• Following are the FDA-approved conditions where bisphosphonates are usually prescribed:

Bisphosphonates are taken as a pill. Or they are injected through an IV (intravenous) infusion if a patient is intolerant of oral bisphosphonates. They must be taken exactly as directed. They may help:

• Reduce bone loss

• Increase bone density in the hip and spine

• Reduce risk of fractures in the spine, hip, and wrist

Side effects may include:

• Heartburn

• Nausea

• Belly (abdominal) pain

• Bone or muscle pain

• Esophagitis, esophageal or gastric ulcers, and gastritis

• IV bisphosphonates cause flu-like symptoms, fevers, myalgias, arthralgias, and headaches within 1 to 3 days of the infusion. The symptoms are mild, stop on their own, usually respond to acetaminophen or NSAIDs, and resolve within a few days.

• Transient hypocalcemia or low calcium level in serum.

• Atypical Femur Fracture (AFF) is a rare complication seen after seven years of bisphosphonate treatment. Plain X-rays of thighs can be used to detect and confirm early diagnosis.

• All bisphosphonates are reported to be associated with a rare complication called osteonecrosis of the jaw It is caused due to higher doses and prolonged duration of exposure in people with pre-existing dental disease, dental implants, dental extraction, and poorly fitting dentures.

Taking bisphosphonates pills

Before you start therapy with bisphosphonates, the following conditions have to satisfied:

• Any calcium and vitamin D deficiencies must be corrected

• Prevent excessive alcohol intake before and during the treatment

• Stop smoking before and during the treatment

• Increase dairy product intake

• If planning an invasive dental procedure, it is recommended to delay the start of bisphosphonate therapy for a few months to allow for healing of the jaw.

Always read medicine information closely. You should not take bisphosphonates if you currently have upper gastrointestinal disease. Certain bisphosphonates must be taken:

• On an empty stomach

• With a full glass of water (8 oz.) first thing in the morning on an empty stomach.

• At least 30 minutes to 1 hour before any food, drink, or other medicines

• While you are upright, either sitting or standing. You should not lie down for at least 30 minutes after taking the medicine to prevent esophageal irritation

• Milk and milk products, coffee, orange juice, and food may decrease the absorption of oral bisphosphonates

Monitoring during the treatment:

When to see your healthcare provider:

Newer medicines can be taken weekly or monthly. Talk with your healthcare provider to find out which one is right for you.