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Bisphosphonate Side Effects

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Bisphosphonate Side Effects

What are the negative effects of bisphosphonates?

Side effects for all the bisphosphonates (alendronate, ibandronate, risedronate and zoledronic acid) may include bone, joint or muscle pain. Side effects of the oral tablets may include nausea, difficulty swallowing, heartburn, irritation of the esophagus (tube connecting the throat to the stomach) and gastric ulcer.

Who should not take bisphosphonates?

Don’t take bisphosphonates if you:
  • Are allergic to them.
  • Have disorders of the food pipe (esophagus), including tears, holes, narrowing, or difficulty swallowing.
  • Have severe kidney disease.
  • Can’t sit in an upright position for at least 30 minutes.
  • Have low levels of calcium in your bloodstream.

What is the danger of taking bisphosphonate medications over a long time?

Long-term bisphosphonate therapy has been linked to a rare type of thigh fracture. This injury, known as atypical femoral fracture, is similar to a stress fracture, causing pain that begins subtly and can gradually worsen. If not identified early on, a complete fracture of the thighbone can occur.

Why do bisphosphonates cause osteonecrosis?

The mechanism by which BPs cause osteonecrosis is not proven but is probably due to a combination of decreased bone remodelling, poor wound healing, and an antiangiogenic effect leading to ischaemic changes and subsequent necrosis in response to a local traumatic insult.

How do bisphosphonates affect dental treatment?

Although bisphosphonates have been proved beneficial for many metabolic bone diseases but due to their action on osteoclast, they impair bone healing and remodelling and this has resulted in increased risk of development of osteonecrosis of jaw (ONJ) following surgical dental procedures like extraction or implant

What do bisphosphonates do to calcium?

Bisphosphonates help prevent your bones from losing calcium and other minerals by slowing or stopping the natural processes that dissolve bone tissue. In doing this, they help your bones remain strong and intact.

Do bisphosphonates affect immune system?

Bisphosphonates are of special interest in populations with impaired immunity and an inability to amount protective antibody responses following immunizations.

Can you drink alcohol while taking bisphosphonates?

Alcohol is unlikely to interact with bisphosphonates. However, heavy drinking is a risk factor for osteoporosis and for having falls so it’s recommended that you drink alcohol only in moderation.

Do bisphosphonates cause weight gain?

Weight gain isn’t a side effect that you should have while taking Fosamax. In clinical trials, weight gain didn’t occur in people taking Fosamax. However, peripheral edema (swelling in your arms or legs) has been reported by some people since Fosamax was approved by the FDA and released onto the market.

How much do bisphosphonates increase bone density?

On average, in a three-year time frame, bisphosphonates increased spine bone density about 5% to 8%, increased hip bone density 3% to 6%, and reduced vertebral fractures by 40% to 70%.

How can I increase my bone density without medication?

10 Natural Ways to Build Healthy Bones
  1. Eat Lots of Vegetables. …
  2. Perform Strength Training and Weight-Bearing Exercises. …
  3. Consume Enough Protein. …
  4. Eat High-Calcium Foods Throughout the Day. …
  5. Get Plenty of Vitamin D and Vitamin K. …
  6. Avoid Very Low-Calorie Diets. …
  7. Consider Taking a Collagen Supplement. …
  8. Maintain a Stable, Healthy Weight.

Is bisphosphonates a chemotherapy?

Last, bisphosphonates in addition to chemotherapy are superior to chemotherapy alone in patients with stages II and III multiple myeloma and can reduce the skeletal morbidity rate by approximately one half.

What is the best exercise for bone density?

Weight-bearing and resistance exercises are the best for your bones. Weight-bearing exercises force you to work against gravity. They include walking, hiking, jogging, climbing stairs, playing tennis, and dancing. Resistance exercises such as lifting weights can also strengthen bones.

Does bisphosphonate cause hair loss?

I recently researched the side effects of this drug and decided to discontinue its use. My first symptom of this drug’s side effect was a sudden increase in hair loss. ANSWER: I found many case reports of hair loss after the use of alendronate (Fosamax) and similar drugs (a class called bisphosphonates).

What are the long term effects of taking Prolia?

Rare, long-term side effects of Prolia include fractures of the spine or femur (thighbone). These are serious. The fractures may require surgeries, take several months to heal, or both. Before you start Prolia treatment, talk with your doctor about how long Prolia’s side effects may last.

How many years can you take Prolia?

In studies, people have safely taken Prolia for up to 8 years. If the drug is working to improve your condition, your doctor may have you take it long term.

Why do bisphosphonates affect the jaw?

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is thought to be caused by trauma to dentoalveolar structures that have a limited capacity for bone healing due to the effects of bisphosphonate therapy.

How can you prevent bisphosphonate-related osteonecrosis of the jaw?

Extraction therapy was the only independent risk factor for BRONJ (p < 0.0001; 95% CI 21.22-189.06). Conclusions: Preventive oral and maxillofacial treatment before bisphosphonate application combined with 3-monthly dental follow-ups significantly reduces the occurrence and risk of BRONJ in PC patients.

Do bisphosphonates cause jaw necrosis?

In osteoporosis, bisphosphonate associated osteonecrosis of the jaw is rare and the incidence may not be greater than the natural background incidence. Epidemiological studies have indicated an estimated incidence of less than 1 cases per 100 000 person-years of exposure to oral bisphosphonates.

Can a tooth be extracted while on Prolia?

Dental side effect of receiving Prolia

Prolia has a side effect in patients who have to have tooth extractions performed. The trauma of the extraction on the bone surrounding the tooth may lead to a condition where the bone dies off, and following the extraction fragments of dead bone are lost from the extraction site.

What are the signs of osteonecrosis of the jaw?

What are the symptoms of ONJ?
  • pain or swelling in the mouth.
  • non-healing of a tooth socket after removal of teeth.
  • loosening of teeth.
  • an area of exposed bone in the mouth.
  • poor healing or infection of the gums.
  • numbness or the feeling of heaviness in the jaw.
  • discharge of pus.

When can I stop using bisphosphonates before tooth extraction?

If systemic conditions permit, the clinician may consider discontinuation of oral bisphosphonates for a period of three months prior to and three months following elective invasive dental surgery in order to lower the risk of BRONJ.

What is IV bisphosphonate treatment?

Background: Intravenous bisphosphonates are widely used for treatment of postmenopausal osteoporosis. They are associated with transient influenza-like symptoms, predominantly after the first zoledronic acid (up to 32 %) or ibandronate (up to 5 %) administration.

What cancers are treated with bisphosphonates?

Bisphosphonate treatment can stop some types of cancer from spreading into the bone for some people. Studies have also shown that bisphosphonates can help some people with breast cancer and myeloma to live longer. Bisphosphonates might also help to: prevent or control bone thinning (osteoporosis)

How effective is bisphosphonate?

Efficacy of bisphosphonate for osteoporotic fracture risk reduction. In the random effects model for all studies, the use of bisphosphonate was associated with a decreased risk of osteoporotic fracture (OR 0.62; 95% CI 0.54 to 0.71 P<0.001).

Is there a lawsuit against Reclast?

Reclast Lawsuit | Side Effects : Femur Fractures, Osteonecrosis of the Jaw (Dead Jaw Syndrome), Esophageal Cancer. Parker Waichman LLP is no longer accepting new cases for this litigation as the litigation has either resolved or the statute of limitation has expired for the defects we were investigating.

Can Reclast cause weight gain?

Tell your doctor if you have serious side effects of Reclast including urinating less than usual or not at all; drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting, swelling, weight gain, shortness of breath, muscle spasms, numbness or tingling (especially around your mouth), …

How do you feel after Reclast infusion?

The infusion was simple and easy. After, I felt no pain or confusion. It is now Sun, 3 days later and I feel exactly as I did on the first day. I’ve drank a total of about 60 oz of water a day, and taken the max dosage of pain relievers a day for the first 2 days.

What is the 6 month shot for osteoporosis?

Prolia (denosumab) is an injection given every 6 months for the treatment and prevention of osteoporosis.

Can vitamin D reverse osteoporosis?

In the 8 studies with greater than 80% compliance, a 24% risk reduction for all fractures was identified. The author’s conclusions were that calcium, or calcium in combination with vitamin D supplementation, was effective in the preventive treatment of osteoporosis in people aged 50 years or older.

Do bisphosphonates make bones more brittle?

Bisphosphonates Cause Brittle, Aged Bone With More Mineralization. The researchers first established that biopsies taken from patients who had developed an AFF showed evidence of elevated tissue mineralization.

Which is better Fosamax or Prolia?

Fosamax (alendronate) is a first-choice treatment for osteoporosis, but taking it can be a hassle. Prevents bone loss. Prolia (Denosumab) is an effective and convenient treatment for osteoporosis if other options haven’t worked or aren’t appropriate for you.

Why do bisphosphonates cause esophagitis?

When bisphosphonates bind, the hydrophobic barrier is destroyed, and gastric acid is able to reach the epithelium resulting in irritation. If bisphosphonates are taken properly, the rate of esophageal irritation is reduced.

Can you drink coffee after taking Fosamax?

Never take alendronate tablets with tea, coffee, juice, milk, mineral water, sparkling water, or any liquid other than plain water.

Do bisphosphonates reverse osteoporosis?

By slowing or stopping the bone-resorbing portion of the remodeling cycle, bisphosphonates allow new bone formation to catch up with bone resorption. Fosamax and other drugs such as Actonel, Boniva, and Reclast increase bone density and help prevent and treat osteoporosis and/or reduce the risk of fractures.

What T score do you start bisphosphonates?

There has been clear data indicating the benefits of placing an osteoporotic patient (T-score: <-2.5) on first-line treatments including bisphosphonates.

How long should drug holiday from bisphosphonates?

Moderate risk of fracture: treat with bisphosphonate for 510 years, offer a ‘drug holiday’ of 35 years or until there is significant loss of BMD or the patient has a fracture, whichever comes first.

Are eggs good for osteoporosis?

Egg intake was positively correlated with radius and tibia cortical bone mineral content and total body bone mineral density. So, incorporating whole eggs into children’s diets is a good strategy to promote a child’s bone development, prevent fractures, and possibly reduce the future risk of osteoporosis.

What is the alternative to taking Prolia?

Are there alternatives to Reclast and Prolia for osteoporosis? There are several other medications that can be used to treat and/or prevent osteoporosis, such as: Other bisphosphonates besides Reclast: Examples of others include ibandronate (Boniva) and alendronate (Fosamax).

Is coffee bad for your bones?

Caffeine leaches calcium from bones, sapping their strength. “You lose about 6 milligrams of calcium for every 100 milligrams of caffeine ingested,” Massey says. That’s not as much of a loss as salt, but it’s worrisome, nonetheless.

Do bisphosphonates make you tired?

Fatigue is a general lack of energy and tiredness that can happen during bisphosphonate therapy. Fatigue makes a person feel more tired than usual and can interfere with daily activities and sleep. It tends to be worse when you are also having other treatments, such as chemotherapy or radiation therapy.

How can I reduce the side effects of bisphosphonates?

Side effects that can occur in a minority of people shortly after receiving an IV bisphosphonate include flu-like symptoms, fever, headache and pain in muscles or joints. Acetaminophen tablets are recommended after the infusion to reduce any body aches that may occur.

Who should not take bisphosphonates?

Don’t take bisphosphonates if you:
  • Are allergic to them.
  • Have disorders of the food pipe (esophagus), including tears, holes, narrowing, or difficulty swallowing.
  • Have severe kidney disease.
  • Can’t sit in an upright position for at least 30 minutes.
  • Have low levels of calcium in your bloodstream.

How should you sleep with osteoporosis?

Lying Down and Getting Out of Bed
  1. When lying on your side in bed, use one pillow between your knees and one under your head to keep your spine aligned and increase your comfort.
  2. When lying on your back in bed, use one or two pillows under your knees and one under your head.

Is banana good for osteoporosis?

As all these nutrients play an essential role for your health, they also improve your bone density. Eat pineapple, strawberries, oranges, apples, bananas and guavas. All these fruits are loaded with vitamin C, which in turn, strengthen your bones.

What does an endocrinologist do for osteoporosis?

Endocrinologists treat the endocrine system, which comprises the glands and hormones that help control the body’s metabolic activity. In addition to osteoporosis, endocrinologists treat diabetes and diseases of the thyroid and pituitary glands.

Does Boniva cause weight gain?

No, weight gain isn’t a known side effect of Boniva. People taking Boniva in clinical studies didn’t report weight gain as a side effect. Weight gain may occur during menopause. And since Boniva is approved for use after menopause, you may gain weight during this time.

Which is better Fosamax or Boniva?

Based on several studies, we know that Fosamax also reduces the risk of hip fractures and nonvertebral fractures. But we aren’t quite sure whether Boniva reduces the risk of hip or nonvertebral fractures. Because of this, clinical guidelines generally recommend Fosamax over Boniva.

How does Reclast affect teeth?

Some people using medicines similar to Reclast have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms of this condition may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

Does Prolia make you gain weight?

Weight gain itself wasn’t reported as a side effect during clinical trials of Prolia. However, some people taking Prolia did have swelling in their arms or legs. And with swelling, your body weight can be quickly increased.

Can Prolia cause extreme fatigue?

The following are common (occurring in greater than 30%) side effects for patients taking Prolia: Fatigue. Muscle weakness. Decreased levels of phosphorus in your blood (hypophosphatemia)

What is the safest medication to take for osteoporosis?

Bisphosphonates are usually the first choice for osteoporosis treatment. These include: Alendronate (Fosamax), a weekly pill. Risedronate (Actonel), a weekly or monthly pill.

Can Prolia cause hair loss?

Does Prolia cause hair loss? In studies, people using Prolia didn’t report hair loss as a side effect. However, hair loss has been reported by people using Prolia after these studies.

What is the difference between Boniva and Prolia?

Are Boniva and Prolia the Same Thing? Prolia (denosumab) and Boniva (ibandronate) are used to prevent and treat bone loss (osteoporosis) in women who are at high risk for bone fracture after menopause. Prolia and Boniva belong to different drug classes. Prolia is a monoclonal antibody and Boniva is a bisphosphonate.

Is Forteo the same as Prolia?

Prolia is primarily used in women who are at risk for osteoporosis after menopause, while Forteo is used in both men and women who have a high risk of bone fracture. Prolia and Forteo belong to different drug classes. Prolia is a monoclonal antibody and Forteo is a man-made form of parathyroid hormone.

How does bisphosphonates affect dental treatment?

Although bisphosphonates have been proved beneficial for many metabolic bone diseases but due to their action on osteoclast, they impair bone healing and remodelling and this has resulted in increased risk of development of osteonecrosis of jaw (ONJ) following surgical dental procedures like extraction or implant

Do all bisphosphonates cause osteonecrosis?

Low-dose bisphosphonate use in patients with osteoporosis or other metabolic bone disease has not been causally linked to the development of osteonecrosis of the jaw. Bisphosphonates have been widely used in the management of osteoporosis and metabolic bone disease.

What happens if jaw bone dies?

Sharp fragments of bone may cause painful tongue sores. Large areas of necrotic bone are sometimes associated with loose or painful teeth that may require extraction. At times, numbness or sharp pain may develop if necrotic bone damages a nerve within the jawbones; this is referred to as neuropathic pain.

How common is jaw necrosis with Prolia?

In cancer patients exposed to denosumab, the risk of ONJ varies from 0.7 to 1.9% (70 to 90 cases per 10,000 patients) (3) and they have been reported to have a risk of developing ONJ similar to that of acid zoledronic (10).

What is the risk of osteonecrosis with Prolia?

The overall incidence of ONJ in patients with cancer receiving denosumab was 1.7% [95% CI: 0.9-3.1%]. The use of denosumab was associated with a significantly increased risk of ONJ in comparison with bisphosphonates (BPs)/placebo treatment (RR 1.61, 95% CI: 1.05-2.48, P = 0.029).

Can osteonecrosis of the jaw be reversed?

Can doctors treat osteonecrosis of the jaw? While there is no specific treatment for ONJ, it can heal on its own with the help of antibiotic rinses and avoiding any other dental surgery.

What are the signs of osteonecrosis of the jaw?

What are the symptoms of ONJ?
  • pain or swelling in the mouth.
  • non-healing of a tooth socket after removal of teeth.
  • loosening of teeth.
  • an area of exposed bone in the mouth.
  • poor healing or infection of the gums.
  • numbness or the feeling of heaviness in the jaw.
  • discharge of pus.

How do I know if I have osteonecrosis of the jaw?

Symptoms of ONJ can range from very mild to severe. ONJ looks like an area of exposed bone in your mouth. It can cause tooth or jaw pain and swelling in your jaw. Severe symptoms include infection in your jaw bone.

Why do bisphosphonates cause jaw necrosis?

The mechanism by which BPs cause osteonecrosis is not proven but is probably due to a combination of decreased bone remodelling, poor wound healing, and an antiangiogenic effect leading to ischaemic changes and subsequent necrosis in response to a local traumatic insult.

Who is at highest risk for developing osteonecrosis of the jaw?

Recent oral surgery, tooth extraction, denture use, and poor oral hygiene are factors that have been implicated in osteonecrosis of the jaw among patients taking bisphosphonates. Other risk factors for osteonecrosis of the jaw have been proposed and may include diabetes, co-morbid conditions, and steroid use.

What are the stages of osteonecrosis of the jaw?

proposed an ONJ classification comprising three stages (31): stage 1 = bone exposure but without signs or symptoms of infection; stage 2 = bone exposure/necrosis with clinical evidence of infection; stage 3 = the above manifestations and also alterati

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