• Bisphosphonates: Patient Information

    What arebisphosphonates used for?

    Bisphosphonates is a prescription medicine used to:

    • Treat or prevent osteoporosis in women after menopause.
    • They helps increase bone mass and helps reduce the chance of having a spinal or non-spinal fracture.
    • They increase bone mass in men with osteoporosis.
    • Treat or prevent osteoporosis in either men or women who are taking corticosteroid medicines.
    • Treat certain men and women who have Paget’s disease of the bone.


    What are the different types of bisphosphonates that are in the market?

    • Oral bisphosphonates: These pills include alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva). Alendronate and risedronate are taken once a week. Ibandronate was approved as the first once-monthly pill.
    • Injectable bisphosphonates: Zoledronic acid (Reclast) was approved as the first once-yearly injection treatment for postmenopausal osteoporosis. Injectable bisphosphonates are an alternative for patients who may have difficulty swallowing pills or sitting upright after oral bisphosphonate treatment.


    How should I take bisphosphonates?

    1.After getting up for the day, swallow your tablet with a full glass of plain water only (Not mineral water/ Not coffee/ Not juice).

    2. After swallowing your tablet do not lie down, stay fully upright (sitting or standing) for at least 30 minutes and until after your first food of the day.

    3. Do not chew or suck on a tablet. This will help the tablet reach your stomach quickly and help avoid irritation of your esophagus.

    3. After swallowing your tablet, wait at least 30 minutes before taking your first food, beverage, or other medication of the day, including antacids, calcium supplements and vitamins.

    4. Do not take the tablet at bedtime or before getting up for the day.


    How does bisphosphonateswork?

    Bisphosphonatesworks by:

    • Reducing the activity of the cells that cause bone loss
    • Decreasing the faster rate of bone loss that occurs after menopause
    • Increasing the amount of bone in most patients


    How should not take these medication?

    Patients with the following features:

    • Certain disorders of the esophagus (the tube that connects your mouth with your stomach)
    • Inability to stand or sit upright for at least 30 minutes
    • Low levels of calcium in their blood
    • Severe kidney disease


    How should I store these medications?

    • Store at 20°Cto25°C.


    What are the possible side effects of bisphosphonates?

    • Some patients may develop severe digestive reactions including irritation, inflammation or ulceration of the esophagus (the tube that connects your mouth with your stomach). These reactions can cause chest pain, heartburn or difficulty or pain upon swallowing.
    • Some patients treated with bisphosphonatesexperienced abdominal (stomach) pain. This is the most commonly reported side effect.
    • Less frequently reported side effects are: 
Nausea, heartburn, irritation or pain of the esophagus (the tube that connects your mouth with your stomach), vomiting, difficulty swallowing, a full or bloated feeling in the stomach, constipation, diarrhea and gas.
    • Bone, muscle or joint pain, headache, or an altered sense of taste were also experienced by some patients.
    • Allergic reactions such as hives or rarely swelling of the face, lips, tongue and/or throat, which may cause difficulty in breathing or swallowing, have also been reported.


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