Bisphosphonates are medications that prevent the re-absorption of bone, which is continually broken down and re-formed. Slowing bone re-absorption increases bone density and helps prevent fractures related to thinning bone. Most bisphosphonates are taken orally, but several bisphosphonates are given intravenously, as infrequently as once a month or once a year.
Gastrointestinal Side Effects
Most gastrointestinal side effects of bisphosphonates are mild and can be decreased or eliminated by taking the drug as directed. Bisphosphonates must be taken first thing in the morning, with a full glass of water on an empty stomach to prevent heartburn and abdominal pain. Staying upright for at least 30 minutes after taking the medication helps decrease the side effects of irritation and possible erosion of the esophagus.
Osteonecrosis of the Jaw
One of the most serious side effects of bisphosphonates is the occurrence of osteonecrosis, which means bone tissue destruction or death, of the jaw. According to a 2006 position paper of the American Academy of Oral and Maxillofacial Pathology, 94 percent of cases of osteonecrosis of the jaw occurred in people receiving intravenous bisphosphonates for the treatment of metastasis of cancer to the bone. However, a small number of cases are related to oral bisphosphonates; 60 percent of cases occur in people who have recently undergone dental procedures or who have poor dental hygiene. Side effects include loose teeth, exposed bone, numbness or heaviness in the jaw, or gums that won't heal, according to the American Dental Association.
Bone, Joint and Musculoskeletal Pain
Transient episodes of bone pain with chills and fever may occur shortly after starting bisphosphonates; these generally resolve within a short time. However, according to an alert issued in 2008 by the Food and Drug Administration, bisphosphonates may also cause severe bone, joint and musculoskeletal pain that may occur months or years after starting the drug.
Ocular Side Effects
According to a 2006 article published in the British Journal of Ophthalmology, bisphosphonates can cause a number of ocular side effects, such as uveitis (inflammation of the uvea, the middle layer of the eye), conjuncitivitis (inflammation of the conjunctiva, the mucus membrane that lines the eyeball and inner part of the eyelid) and blurry vision.
Allergic Side Effects
Like any drug, bisphosphonates can cause allergic reactions such as rashes, hives, chest pain, itching or swelling.
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