Bisphosphonates Print Page
What are bisphosphonates?
- Bisphosphonates are a group of drugs that help slow bone loss. They help to keep your bones to strong and prevent them from thinning (osteoporosis).
- Using them long-term can decrease your risk of having a broken hip or a spine fracture.
What is the typical dose?
- The dose depends on which bisphosphonate you take:
- Alendronate (Fosamax®)
- 70mg once WEEKLY in the morning, on an empty stomach with a full glass of plain water.
- Do not take with other food, medications, calcium or dairy products.
- Stay upright for 30 minutes after dose.
- Risedronate (Actonel®)
- 35mg once WEEKLY, on an empty stomach with a full glass of plain water OR
- 150mg once MONTHLY, on an empty stomach with a full glass of plain water.
- Do not take with other food, medications, calcium or dairy products.
- Stay upright for 30 minutes after dose.
- Zoledronic Acid (Aclasta®) – 5mg once YEARLY by injection over 15 minutes
- Drink at least 2 glasses of water before and after the treatment.
How do bisphosphonates work?
- In osteoporosis, your body removes more bone than it replaces. Bisphosphonates help correct this by slowing down the body’s rate of bone removal. Your bone thickness is measured by a test (bone mineral density) and this is one way we check to see if the bisphosphonate is working for you. The other is determining if you’ve had a fracture.
What are the possible side effects of bisphosphonates?
- Common:
- Stomach pain, heartburn, nausea, pain in bones, muscles
- Get better with time.
- If you have a history of esophagus problems or kidney problems, inform your doctor/pharmacist before starting the medication.
- Talk to your doctor or pharmacist if it is severe.
- Stomach pain, heartburn, nausea, pain in bones, muscles
- Less common:
- Low calcium levels (numbness, tingling, muscle spasms)
- Discuss your calcium intake with your doctor, pharmacist, or dietitian. They can help you manage this.
- Low calcium levels (numbness, tingling, muscle spasms)
- Rare:
- Wounds in your jaw from limited blood supply
- Talk to your dentist before having dental work done.
- Tell your doctor if you have persistent pain in your mouth or jaw.
- Unusual break in your thigh bone
- Talk to your doctor if you have new or unusual pain in your hip or thigh.
- Wounds in your jaw from limited blood supply
- Side effects with zoledronic acid infusion
- Flu like symptoms during and after the dose infusion (fever, fatigue, chills, feeling unwell)
Are there medications I should avoid when taking bisphosphonates?
- Avoid supplements with calcium, magnesium or iron within 2 hours of taking the medication, as it may decrease absorption.
What do I do if I miss a dose?
- For weekly dosing, take 1 tablet on the day you first remember having missed your dose. Then resume your normal schedule on your regular day of the week. Do not take 2 doses on 1 day.
- For monthly dosing, if the next month’s dose is MORE than 7 days away, take the missed dose on the morning you remember. Otherwise, wait until the next scheduled dose.
How long will I have to be on bisphosphonates?
- Each patient is different. It depends on your risk for having a fracture over the next 10 years. Talk to your doctor or pharmacist before deciding to stop your medication.