What are Bisphosphonates?

Bisphosphonates are a group of medications used to reduce the deterioration of bone loss. They include the medications risedronate, alendronate, zoledronic acid, and ibandronate. These medications are typically prescribed as a form of treatment for osteoporosis, a condition that causes weakening of the bones.

As bones become thinner and lose their density, they are at a higher risk of fracturing or breaking from a light fall. Bisphosphonates are classified as antiresorptive, a term that refers to their ability to thicken bone mass. Once the bones are thicker, they can withstand more force and can help protect people with osteoporosis or other bone thinning conditions from injuring themselves.

Although the medications may help treat or prevent bone loss, they can potentially cause harmful side effects. People may have trouble swallowing or experience pain after eating due to an inflamed esophagus. Taking bisphosphonates may also result in slowed healing of the jaw bones, so people who are on the medication are typically not advised to have serious dental surgery without consulting with their doctors.

The side effects of the medications can be reduced if a person takes it on an empty stomach and remains upright for at least 30 minutes afterward. Laying down immediately after taking the medication can increase the risk of esophagus inflammation. People who are on bed rest will typically not be able to safely take the medication.

Bisphosphonates are available in both oral capsules and injections. The dosage often varies widely depending on the severity of the bone loss. Oral capsule dosage recommendations may range from daily to just once a month. Injections also have a wide dosage range, so a doctor may administer them once every three months or may prescribe a once yearly dose.

People who have low bone mass will typically have a deficiency in calcium and vitamin D because their weakened bones cannot properly absorb the nutrients. They will often take calcium and vitamin D supplements, which can lose their effectiveness when taken at the same time as bisphosphonates. A doctor may recommend a person separate the supplements and medication by taking them at different times of the day.

Certain groups of people may not be able to safely take these medications. Women who are pregnant or breastfeeding should not take them because the effects of the medication on children are not conclusively known. Since the medication can irritate parts of the digestive system, people with serious kidney or esophageal conditions may not be able to safely take them without worsening their conditions.