Bisphosphonates for osteoporosis

Medically Reviewed By : Dr K. Hari Chandana

( Fellowship in Trauma, Fellowship in Pain Management )


Bisphosphonates are the class of drugs  that have been used for Osteoporosis for decades. They are proven to be effective in treating osteoporosis and prevention of fracture of bones. 

Bisphosphonates are decades older drugs for osteoporosis, commonly used by physicians. They are called Bis or diphosphonates.

 Osteoporosis is a disease of bones which weakens them to the extent that they are easily broken causing fractures and sometimes big joints causing the patient immobile.

Now, what exactly do normal bones function and how does it ends up in osteoporosis in only certain patients?

The answer is – Normal bones have a cycle of formation and resorption. There are two types of bone cells, osteoblasts which involve the formation of cells of new bone whereas osteoclasts help the resorption of bone means the death of old bone. When a patient suffers from osteoporosis, this mechanism is disturbed. The formation of new bone cells doesn’t take place, and old bone cells resorb, so the bone becomes porous and spongy.

Bisphosphonates for osteoporosis

Then what do bisphosphonates do?

 Bisphosphonates are molecules which are very similar to the molecule present in the bone called pyrophosphate. Pyrophosphate molecule is resorbed by osteoclasts.

              Bisphosphonates are very difficult for the osteoclasts to identify and resorb so this group of drugs helps in the late resorption of bone, resulting in the prevention and progression of osteoporosis. This establishes the fact that bisphosphonates are preventive medicines for osteoporosis

What are the benefits of taking bisphosphonates:

Do bisphosphonates have serious side effects?

 yes, it can have serious side effects but not in all patients The FDA has approved bisphosphonates for the treatment and prevention of osteoporosis.

What all common side effects constitute:

The above side effects can be treated with medications, and they resolve completely.

What are Some serious side effects of bisphosphonates:

What are the conditions that Bisphosphonates treat other than osteoporosis?

How to take bisphosphonates

Furthermore, your doctor will advise you to take a calcium-rich diet or calcium supplements, as well as Vitamin D supplements if you have Vitamin D deficiency.

Have you heard Bisphosphonates are taken in a sitting position?

Yes, you heard right. Bisphosphonates have a mode of action 

So, the patient is instructed to take the oral tablet in an upright position in the morning on an empty stomach. Patient has to sit or stand upright for 30 to 60 minutes. Generally, no food or drink is allowed after taking a tablet for 30-60 minutes.

Why follow so many instructions to take a tablet?

  You must be wondering, yes you have to follow the rules who are taking tablets orally.

 As already discussed in the article earlier, bisphosphonates are well known to cause side effects like GERD (gastroesophageal reflux disease) and gastritis.  To avoid side effects, you are instructed to follow rules and those who don’t comply, experience serious side effects.