Login
Subscribe
Your newsletter is always warning about the risk of taking bisphosphonates for osteoporosis. But you recommended these drugs in your September 2015 issue. Why did you contradict yourselves?
It is true that we often have discussed the risks of bisphosphonates, including jawbone damage[1] and the risk of unusual fractures, with long-term use.[2] But all drugs have risks, and having serious risks does not automatically place a drug into the Do Not Use category, provided it also carries...
Your newsletter is always warning about the risk of taking bisphosphonates for osteoporosis. But you recommended these drugs in your September 2015 issue. Why did you contradict yourselves?
It is true that we often have discussed the risks of bisphosphonates, including jawbone damage[1] and the risk of unusual fractures, with long-term use.[2] But all drugs have risks, and having serious risks does not automatically place a drug into the Do Not Use category, provided it also carries important benefits.
Bisphosphonates have been proven effective at preventing hip fracture, at least when used for a limited time by people who are at extremely high risk.[3] Hip fractures can be very serious, leading to premature death or long-term disability.[4]
Therefore, Public Citizen’s Health Research Group recommends three bisphosphonates — alendronate (BINOSTO, FOSAMAX), ibandronate (BONIVA) and risedronate (ACTONEL, ATELVIA) — for limited use. This means these drugs should be used only by people at very high risk of fracture (usually older people with very low bone density who already have had a fracture due to osteoporosis) and only for a limited time (generally, for five years or less).[5],[6]
However, we have designated one bisphosphonate, zoledronic acid (RECLAST), as Do Not Use because it has a greater risk of side effects and offers no important clinical benefits over other options.[7]
See our article “A Guide to Treatments for Osteoporosis” in the May 2015 issue of Worst Pills, Best Pills News for more information.
References
[1] Death of parts of the jaw bone with osteoporosis drugs such as alendronate (FOSAMAX). Worst Pills, Best Pills News. September 2006. /newsletters/view/484. Accessed February 6, 2016.
[2] Long-term use of bisphosphonates for osteoporosis. Worst Pills, Best Pills News. January 2009. /newsletters/view/624. Accessed February 6, 2016.
[3] A guide to treatments for osteoporosis. Worst Pills, Best Pills News. May 2015. /newsletters/view/960. Accessed February 6, 2016.
[4] Ibid.
[5] Drug Profile: alendronate (BINOSTO, FOSAMAX); risedronate (ACTONEL, ATELVIA). WorstPills.org. Last reviewed July 31, 2015. /monographs/view/67. Accessed February 6, 2016.
[6] A guide to treatments for osteoporosis. Worst Pills, Best Pills News, May 2015. /newsletters/view/960. Accessed February 6, 2016.
[7] Ibid.
