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Last Updated: Oct 23, 2019
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Osteoporosis - How Bisphosphonates Can Be Of Help?

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Dr. Mukesh NakumOrthopedic Doctor • 15 Years Exp.MS - Orthopaedics, Fellowship in Joint Replacement
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Bisphosphonates are the most commonly prescribed medicine for osteoporosis patients. This medicine is taken for no more than three to five years in a stretch. A doctor typically takes a call after this time period to find out whether it is suitable for the patient to continue the medicine for a longer time based on the individual risk factors.

Bisphosphonates contain four main ingredients namely Relcast, Fosamax, Boniva and Atelvia. This medicine slows the rate of bone loss and reduces the risk of fracture. This being said, there are some potential side effects of Bisphosphonates as well:

  1. Problems in the jawbone: Consumption of Bisphosphonates can lead to a condition known as the osteonecrosis. This is a disease of the jawbone swelling, pain, and infection of the jawbone. The risk increases if a patient goes through an invasive surgery such as tooth extraction.
  2. Thigh bone fracture: Prolonged intake of Bisphosphonates is believed to be a rare kind of thigh fracture known as the atypical femoral fracture. This is very similar to a stress fracture that causes subtle pain and worsens with time.
  3. Stomach upset: Bisphosphonates intake can lead to oesophageal ulcers and sharp pain in the abdomen. It can also lead to mild fever lasting for a time period of 2-3 days along with upset stomach and body ache. This symptom mostly occurs when there is an irregularity in taking the medicine.

Choosing the right Bisphosphonates:
Drugs of the Bisphosphonates class are similar in nature. While some vary in terms of maintaining potency and bone density, the overall effectiveness of this drug is on the higher side. The common aim of this drug is to reduce the rate of fracture. The decision of choosing a drug over another depends on factors such as cost, preference, convenience and tenacity to stick to the exact dosage. Doctors often prescribe the monthly dosage at one go. The dosage can also be prescribed on a weekly basis depending on the patient’s convenience.

The effect of Bisphosphonates:
Consumption of intravenous Bisphosphonates is considered to be the best medicine for fracture prevention. It is, therefore, very unlikely that a patient with osteoporosis will see additional improvement once he has taken Bisphosphonates for more than three years. This is perhaps the reason why most doctors suggest stopping this medicine after a patient consumes this for more than 3 years. Some other factors that a doctor considers while making this decision include past history of fractures, the age of the patient and the present bone density. If however, the bone density gets worse, a doctor can always restart Bisphosphonates until further improvement is witnessed. This again depends on the patient’s medical condition at the time of check-up.

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