What is osteoporosis?
Osteoporosis is a
progressive disease that causes your
bones to become thin and brittle, significantly
increasing your risk for fractures of the
vertebrae and hip. These fractures may require
hospitalization, can cause loss of height and severe back pain, and may lead to
What are bisphosphonate medicines?
Bisphosphonates, such as alendronate (Fosamax), slow
the rate at which bone dissolves and is absorbed into the body, resulting in
increased bone density and strength.
Studies show that
bisphosphonates decrease the risk of fractures, including fractures of the
vertebrae and the hip, by as much as 50%.1 And one
study showed a 70% decrease in vertebral fractures in people taking zoledronic
Bisphosphonates are the most
commonly prescribed medicines for osteoporosis. But bisphosphonate medicines
may not be right for you. Depending upon your medical history and current
condition, your health professional may recommend other osteoporosis medicines,
- Raloxifene (Evista).
- Calcitonin (Calcimar or Miacalcin).
- Teriparatide (Forteo).
- Hormone replacement therapy (HRT) or
estrogen replacement therapy (ERT).
While bisphosphonates can be taken instead of hormone
replacement therapy for osteoporosis in postmenopausal women, bisphosphonates
will not help hot flashes or other symptoms of
How are bisphosphonates taken?
bisphosphonates are taken by mouth on a daily, weekly, or monthly basis. You
should take this medicine with a full glass of water in the morning on an empty
stomach. Stay upright and wait 30 minutes before eating or drinking anything or
taking another medicine.
Zoledronic acid and one form of
ibandronate are given
intravenously. Most people using zoledronic acid are
given just one intravenous infusion each year. In most cases, ibandronate is
given every 3 months.
If you are taking medicines for
osteoporosis, you should also be taking calcium and vitamin D supplements. You
should take calcium and vitamin D at least 2 hours before or after taking
What are the side effects of taking bisphosphonate medicines?
If the medicine is taken as directed, side effects are
uncommon but they may include headache, pain in your muscles and joints,
constipation, diarrhea, and increased gas. If you take the medicine by mouth,
side effects can also include
heartburn, abdominal pain, irritation of the
esophagus, and difficulty swallowing. It may take
several months for heartburn to appear.
Allergic reactions are rare.
problems with bone healing, particularly after dental surgery, have been found
in some people taking bisphosphonates.3 Talk with your
doctor if you are taking bisphosphonates or are about to start taking them, and
need dental surgery.
Because these are relatively new medicines,
their long-term effectiveness has not been studied. Most experts recommend that
you have a
bone mineral density (BMD) test after taking
bisphosphonates for 2 years.4 But getting regular bone
mineral density tests will not make bisphosphonates work better.5
Bisphosphonates should not be taken by people who have severe kidney
problems. Oral bisphosphonates should not be taken by people who have heartburn
or esophagitis. Bisphosphonates should not be taken with teriparatide, as
neither medicine is as effective when taken together. But bisphosphonates may
be taken together with HRT because the effect of these two medicines taken
together is more than either alone.
If you need more information, see the topic