Bisphosphonates are a group of drugs used to help prevent and treat bone loss. They're prescribed for people with osteopenia (softening of the bones), osteoporosis (brittle and easily broken bones), Paget's disease, and certain bone cancers. These drugs work by interfering with the process through which the body breaks down bone tissue.
What should be considered if a patient is taking bisphosphonates?
If a patient is already taking bisphosphonates, the following should be considered: Routine dental treatment does not need to be modified if the only issue is the use of bisphosphonates. Oral bisphosphonates can result in BON, but the risk is much lower than with IV bisphosphonates. The risk for developing BON may be minimized but not eliminated.
What are the benefits of bisphosphonates for bones?
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.
Should hygienists use bisphosphonates for periodontal treatment?
According to the ADA report, bisphosphonate users with periodontal disease should receive nonsurgical therapy whenever possible. This has implications for hygienists. Patients with periodontal disease who take bisphosphonates may be appropriate candidates for periodontal scaling and root planing. (D4341)
Are bisphosphonates associated with gastrointestinal irritation carcinogenic?
This raises the question of a possible carcinogenic role of bisphosphonates associated with gastrointestinal irritation. Obviously, millions of patients have taken oral bisphosphonates since alendronate was FDA-approved in 1995.
What are bisphosphonates?
Bisphosphonates, also called diphosphonates, are a class of drugs that have been used commonly for more than two decades for the treatment and prev...
Do bisphosphonates cause esophageal cancer?
There has been concern about a possible association between esophageal cancer and oral bisphosphonate use, however the FDA has not concluded that p...
Do bisphosphonates cause osteonecrosis of the jaw?
There has been a lot written on a possible relationship between bisphosphonates and a condition called osteonecrosis of the jaw (ONJ), which refers...
How is osteonecrosis of the jaw treated?
When avascular necrosis of the jaw develops, it remains unclear how best to treat it. This has led to the great concern that both patients and heal...
What are other side effects of bisphosphonates?
Uncommon side effects of bisphosphonate therapy include fractures of the femur (such as a hip fracture) and inflammatory eye disease.
What are the risks and benefits of bisphosphonates?
As when any medication is prescribed, the risks and benefits of that medication must be considered. For the treatment of osteoporosis, patients mus...
How are bisphosphonates administered?
They are administered in two ways: orally and intravenously. Bisphosphonates include the following medications: Alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva) are available orally. The former two agents can be taken daily or weekly; the latter two agents can be taken daily or monthly.
What is a bisphosphonate?
What are bisphosphonates? Bisphosphonates, also known as diphosphonates, are a class of drugs that have been used commonly for more than two decades for the treatment and prevention of osteoporosis. Bisphosphonates slow bone resorption by reducing osteoclast function. Many studies have shown that this class of medication can improve bone density ...
How often is ibandronate given?
The former two agents are generally given every three to four months, and the latter agent yearly. Pamidronate was the first available intravenous bisphosphonate.
How many cases of esophageal cancer were identified in the US in 2008?
In Europe and Japan, 31 cases of esophageal cancer were identified as possibly related to bisphosphonate use.
How long should you stay upright after taking a sulfate supplement?
Because of this, patients are instructed to remain upright for 30 to 60 minutes after ingestion. This is felt to improve both absorption and to promote gastric motility and reduce the time available for these agents to irritate the upper gastrointestinal tract.
Can you take etidronate daily?
etidronate (Didronel) Alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva) are available orally. The former two agents can be taken daily or weekly; the latter two agents can be taken daily or monthly. Pamidronate (Aredia), ibandronate (Boniva) and zoledronic acid (Boniva) are available intravenously.
Can bisphosphonate cause eye inflammation?
Inflammatory eye disease. Data suggests that scleritis and uveitis, which are types of eye inflammation, may also be rare side effects of bisphosphonate therapy. Symptoms are often a red, painful eye that is sensitive to light. The condition can usually be treated with eye drops.
What is the purpose of bisphosphonates?
These drugs are used to treat several conditions associated with bone loss. Bisphosphonates are a group of drugs used to help prevent and treat bone loss. They're prescribed for people with osteopenia (softening of the bones), osteoporosis (brittle and easily broken bones), Paget's disease, and certain bone cancers.
When to take bisphosphonate?
Except for Altevia, all pill forms of bisphosphonates should be taken on an empty stomach before eating breakfast — generally 30 minutes beforehand. Take Boniva on an empty stomach 1 hour before eating; Altevia should be taken after meals.
How often do you give Actonel and Boniva?
Actonel or Altevia (risedronate) Fosamax (alendronate) Boniva (ibandronate) Reclast or Zometa (zoledronic acid) Reclast and Zometa ( zoledronic acid) are administered by intravenous (IV) injection once a year. The other bisphosphonates come in pills, taken orally.
What are the side effects of bisphosphonates?
The most common side effects of bisphosphonates are stomach irritation and heartburn, but these problems are often avoided by taking the medication correctly. Other common side effects include: Bone or joint pain, or generalized pain. Muscle cramps or aches. Nausea, constipation, diarrhea, or other stomach discomfort.
How long do you have to stay upright after taking bisphosphonate?
Have low levels of calcium in your bloodstream. To avoid irritation to your stomach and food pipe, you must remain in an upright position for at least 30 minutes after taking a bisphosphonate by mouth. Boniva requires you to remain upright for 1 hour.
What is the best medicine for magnesium?
Magnesium-containing drugs like Milk of Magnesia ( magnesium hydroxide) or Maalox (magnesium with aluminum) Diuretics or " water pills " such as Lasix ( furosemide) or Edecrin (ethacrynic acid) Antbiotics like Amphosin and Fungizone (amphotericin B), amikacin, or gentamicin.
Can you take bisphosphonate if you have a stomach problem?
Warnings and Precautions. Don't take bisphosphonates if you: Have disorders of the food pipe (esophagus), including tears, holes, narrowing, or difficulty swallowing. To avoid irritation to your stomach and food pipe, you must remain in an upright position for at least 30 minutes after taking a bisphosphonate by mouth.
What is bisphosphonate used for?
Bisphosphonates are a class of drugs used to treat various systemic problems, chiefly osteoporosis and tumors associated with certain types of cancer. Thousands of men and women take the drugs, which can be administered orally or intravenously. According to the American Dental Association Council on Scientific Affairs ...
What are oral bisphosphonates?
Oral bisphosphonates include, but are not limited to, Actonel, Boniva, Didronel, Fosamax, and Skelid. Intraveous bisphosphonates include, but are not limited to, Aredia, Bonefos, Boniva IV, Reclast, and Zometa.
What blood test is used to determine if you have bisphosphonate?
According to Dr. Robert E. Marx, author of a book on bisphosphonate therapy and BON, a Serum CTX blood test (serum C-terminal telopeptide test) and NTX test (urinary N telopeptide of type I collagen) can be performed to measure the risk of BON.
What is bisphosphonate associated osteonecrosis?
The lesions associated with bisphosphonate associated osteonecrosis (BON) are described as “ragged, oral mucosal ulcerations that expose underlying bone and often are extremely painful. The lesions are persistent and do not respond to conventional treatment modalities such as debridement or antibiotic therapy.”.
How is bone mass maintained?
Bone mass is maintained by a balance between bone cell destruction and bone cell generation (osteoblast activity). When the balance is changed due to the suppression of osteoclasts, it appears that normal bone repair may be impacted. The Journal of Oral and Maxillofacial Surgery (2005) reported that “bisphosphonate-associated osteonecrosis of the jaw occurs mainly in the oral cavity because the jaws have a greater blood supply than other bones and a faster turnover rate, resulting in a high concentration of bisphosphonates.”
Why is bisphosphonate osteonecrosis of the jaw a problem?
The Journal of Oral and Maxillofacial Surgery (2005) reported that “bisphosphonate-associated osteonecrosis of the jaw occurs mainly in the oral cavity because the jaws have a greater blood supply than other bones and a faster turnover rate, resulting in a high concentration of bisphosphonates.”.
Should you have an oral exam before taking bisphosphonates?
According to the AAOMS, patients should have an oral exam, and any unsalvageable teeth should be removed prior to taking the drugs. Any invasive dental procedures should be completed, and optimal periodontal health should be achieved. If a patient is already taking bisphosphonates, the following should be considered: