Trade Name(s):
Available
Dose
Indications
Prevention or treatment of osteoporosis
Side Effects
Nausea, vomiting, abdominal pain, or change in bowel movements are the most common side effects. Rarely, bleeding may occur, although the risk is much higher in patients with strictures in the esophagus or in those at high risk for ulcer disease. Headache, bone/muscle pain, and an altered taste sensation are less common side effects.
Monitoring
Follow-up bone density testing is recommended every 1-2 years to assess efficacy of therapy. Urinary markers of bone turnover, which should be suppressed on bisphosphonates, are another way to monitor the therapeutic effect of these medications. Yearly blood counts and blood chemistry studies are prudent, particularly calcium, phosphorus, and magnesium levels.
Important Points to Know
All oral bisphosphonates should be taken after getting out of bed for the day prior to consuming any food or liquids. Do not take these medications at bedtime or any other time of the day. The medication should be swallowed with a full glass (6-8 oz.) of plain water only. Do not use mineral water, coffee, tea, juice, or other liquids. Do not chew or suck on these tablets. After swallowing the tablet, do not lie down; stay fully upright (sitting, standing, or walking) or consume any food, liquids, or medications (including antacids) for at least 30 minutes. These guidelines prevent complications from the medication staying in contact too long with the lining of the esophagus, allow passage of the medication into the stomach, and ensure that the drug is properly absorbed. If you have chest pain, new or worsening heartburn, or pain with swallowing, call your health care provider for further guidance. Also alert your provider if you have a history of swallowing difficulties, strictures in the esophagus, have impaired kidney function, low blood levels of calcium, or are unable to sit or stand upright for 30 minutes after taking the medication.