Bisphosphonates
- Suppress osteoclast-mediated bone resorption
- First-line osteoporosis drugs for many patients
- Alendronate/risedronate oral; zoledronate IV
- ↓ vertebral and hip fracture risk
- Oral drugs can irritate esophagus
- Rare ONJ + atypical femur fracture
- Long-term need → consider drug-holiday strategy
Class at a glance
- Suppress osteoclast-mediated bone resorption
Members / distinctions
- Alendronate/risedronate oral; zoledronate IV
- Oral drugs can irritate esophagus
Other member distinctions
- Rare ONJ + atypical femur fracture
- Long-term need → consider drug-holiday strategy
Safety / monitoring
- First-line osteoporosis drugs for many patients
- ↓ vertebral and hip fracture risk
Pearls
- Atypical femur fracture risk rises with treatment duration
- Fractures prevented far outnumber atypical femur fractures
- After 5 years, shorter extension linked to fewer hip fractures
Self-check
- Which drug class is first-line for osteoporosis in many patients?
Bisphosphonates. - What organ can oral bisphosphonates irritate?
The esophagus.
Drugs in this class (5)
Bisphosphonates prescription history
Animated chart of estimated U.S. prescriptions per year, Osteoporosis meds (1975–2026). Bisphosphonate highlighted from 1995.
All drug classes · Open Bisphosphonates in the interactive console ↗