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What is bisphosphonates ?

Bisphosphonates are drugs used for the treatment and prevention of bone thinning or osteoporosis, which occurs when the bones lose calcium and other minerals that are needed in keeping them compact and strong. The condition may lead to bone pain, fractures, and shorter stature. Every person is at risk for the condition as they age, with women at a greater risk of the condition after menopause. Studies have shown that people with lupus are at increased risk for osteoporosis because of the inflammation that comes with the disease. Some medications taken to treat lupus may also increase the risk of osteoporosis, especially some corticosteroids such as prednisone.

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Mechanics of action

The human bones are constantly remodeling in a process that continually removes old bone cells and deposits new ones. In people with osteoporosis, the bones are losing minerals faster than they can be regenerated. 

Bisphosphonates help in preventing your bones from losing calcium and other minerals by stopping or slowing the natural process that dissolves bone tissue. Doing this will help your bones stay intact and strong. If you have already developed osteoporosis, bisphosphonates may slow the thinning of your bones and prevent your bones from fracturing. Studies have shown that risedronate and alendronate can lower your risk of fractured vertebrae by half. Other studies demonstrate that these medications can lower by 30 to 49% the chance of breaking other bones.

Usual doses

Most bisphosphonates are taken from once a week to once a month. All of the bisphosphonate medications are in tablet form, with the exception of zoledronic acid that is administered intravenously once yearly. Bisphosphonates may be taken by both men and women.

Bisphosphonates must be taken in the morning with a full glass of water at least 30 minutes before eating, drinking, or ingesting other medications. Refrain from lying down within 30 minutes of taking the medication.

Side effects

Potential side effects of bisphosphonates include:

Some individuals experienced problems with bone healing after dental extractions or implants. Make sure to talk to your doctor if you plan to have this type of treatment since he might stop you from taking these medications before the procedure and start taking an antibiotic. Talk also to your doctor if the side effects that you experience are bothersome.


The following individuals must not take these medicines unless approved by the doctor:

  • People with severe kidney problems
  • Pregnant women or women who are planning to get pregnant
  • People who are taking the parathyroid hormone, with some exceptions
  • People with inflammation of the esophagus

Talk to your doctor if you have hypocalcemia or low blood calcium, kidney disease, a vitamin D deficiency, or an ulcer in your esophagus or stomach, since your doctor may advise you against taking these medications.