Bisphosphonates for Osteoporosis

Bisphosphonates are not usually recommended for people with severe kidney disease. Your doctor will test your kidney function before prescribing bisphosphonates, especially if you are considering zoledronic acid (Reclast).

If you are considering a bisphosphonate that is taken by mouth, be sure to tell your doctor if you have ever had serious heartburn or problems with your esophagus (the tube that connects your throat to your stomach).

For the best results and to reduce the risk of irritation to your Reference esophagus Opens New Window Reference Opens New Window if you take bisphosphonates by mouth:

• Most of these medicines should be taken in the morning with a full glass of water at least 30 minutes before eating a meal, drinking a beverage, or taking any other medicine. If your doctor prescribes the form of risedronate called Atelvia, take it right after breakfast with a glass of water.
• Sit or stand (don't lie down) for at least 30 minutes after taking a bisphosphonate. This helps prevent heartburn.
• Do not take a bisphosphonate late in the day if you forgot to take it in the morning.

Tell your doctor if you notice any new or increasing problems with swallowing. Problems could include feeling pain when you swallow or feeling like you have a lump or sore in your throat.

Tell your doctor if you notice pain in your thigh or groin. Some research suggests that taking bisphosphonates for a long time may slightly increase the risk of breaking the thigh bone.

Serious problems with bone healing, particularly after dental surgery, have been found in some people who are taking bisphosphonates.^{Reference 2} If you are taking bisphosphonates and need dental surgery, talk with your doctor.

It is not clear how long you should take bisphosphonates. Experts have suggested that taking bisphosphonates for 3 to 5 years may be enough if you are at low risk of fractures. Talk to your doctor about how long you should take these medicines.

If you are taking bisphosphonates, your doctor may also recommend that you take calcium and vitamin D supplements. But Reference calcium supplements Opens New Window may interfere with your body's ability to absorb bisphosphonates, so take your bisphosphonate and your calcium supplement at least half an hour apart.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Reference Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a Reference PDF Opens New Window document?) to help you understand this medication.

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