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My doctor told me that patients with impaired kidney function should not take bisphosphonates, but there was no discussion of this issue in your October 2021 article “Oral Bisphosphonates for Osteoporosis: Important Warnings.” Could you address this topic?
Bisphosphonates are removed from the body by the kidneys, and excessive amounts of these drugs may accumulate in the bodies of patients with severe kidney impairment. Therefore, the Food and Drug Administration-approved product labels...
My doctor told me that patients with impaired kidney function should not take bisphosphonates, but there was no discussion of this issue in your October 2021 article “Oral Bisphosphonates for Osteoporosis: Important Warnings.” Could you address this topic?
Bisphosphonates are removed from the body by the kidneys, and excessive amounts of these drugs may accumulate in the bodies of patients with severe kidney impairment. Therefore, the Food and Drug Administration-approved product labels for alendronate (BINOSTO, FOSAMAX),[1] ibandronate (BONIVA)[2] and risedronate (ACTONEL, ATELVIA)[3] all state that these drugs are not recommended for use in patients with severe kidney impairment, defined as a creatine clearance (a laboratory test routinely used to measure kidney function) of less than 30 to 35 milliliters/minute. For patients with kidney impairment that is less than severe, no dosage adjustment of these bisphosphonates is needed. Before taking any bisphosphonate, be sure to tell your doctor if you have kidney problems and ask about your creatine clearance.
References
[1] Ascend Therapeutics. Label: alendronate (BINOSTO). March 2021. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=b278a11a-b8d7-49f3-9b38-29b67c4c417e&type=display. Accessed December 15, 2021.
[2] Genentech USA, Inc. Label: ibandronate (BONIVA). October 2020. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=841bf769-0148-42a8-a4d0-ff062b4734e8&type=display. Accessed December 15, 2021.
[3] Allergan USA, Inc. Label: risedronate (ACTONEL). November 2019. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=24ed00e0-25e2-49a8-97fc-66c1b417dc0b&type=display. Accessed December 15, 2021.
