Deciding About Bisphosphonate Medicine for Osteoporosis

How can you decide about taking bisphosphonate medicine for osteoporosis?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand the risks and benefits so that you can talk to your doctor about what's right for you.

What is osteoporosis?

Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle and have lots of holes inside them like a sponge. This makes them easy to break. It can lead to broken bones (fractures), especially in the hip, spine, and wrist. These fractures may make it hard for you to live on your own.

Bisphosphonates are the most common medicines used to prevent bone loss. They may be taken as a pill or an injection into a vein. Bisphosphonates slow the way bone dissolves and is absorbed by your body. They can increase bone thickness and strength.

What are key points about this decision?

• If you are at a higher risk of having a fracture, taking bisphosphonates is more likely to help you prevent a fracture. If your risk of a fracture is lower, it's less likely that these medicines will help you.
• Bisphosphonates can cause problems with the jawbone or thighbone. But most people do not have these side effects.
• Whether you take medicine or not, healthy habits can help protect your bones. Get enough calcium and vitamin D. Do regular weight-bearing or resistance exercises. Cut back on alcohol. And if you smoke, try to quit. Talk to your doctor if you need help quitting.

Who is helped the most by bisphosphonates?

For women who have been through menopause or men over the age of 50:

• Bisphosphonates will lower your risk of fracture if you have osteoporosis (your T-score is -2.5 or less) or you have had a fracture in your hip or spine .
• Bisphosphonates may help if you have low bone density (your T-score is between -1.0 and -2.5, sometimes called osteopenia), and you are at a high risk for a fracture or have had a fracture in certain places, including your upper arm or pelvis.

What are the side effects of bisphosphonates?

These medicines can have side effects, such as heartburn and belly pain. They can also cause a fever and body aches for a few days after you start the medicine.

Certain problems with the jawbone and fractures of the thighbone have been reported in a very small number of people. The risk of fracture from not treating osteoporosis is higher than the risk of these side effects.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.