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How Long Can You Safely Take Bisphosphonate Medication for Osteoporosis?

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Bisphosphonates are the drugs most often prescribed to treat and prevent osteoporosis. Bisphosphonates help to preserve bone mass by slowing down bone resorption. Clinical studies of these drugs have focused on their effect on bone mineral density (BMD) and fracture risk. Members of this drug class include Fosamax, ibandronate (Boniva), Actonel and Reclast.  

A reader asks:  I took one bisphosphonate for four years and another for one year; however, the changes to my BMD have been minimal. Now my doctor suggests continuing the medication I'm on for another year, but I've heard you shouldn't take a bisphosphonate for more than five years. What is my next step? 

Here’s our advice:  Guidelines for long-term use of bisphosphonates from groups like the National Osteoporosis Foundation have recently been updated to reflect new findings on the benefits and risks of that class of drugs. That said, however, there is no one-size-fits-all approach to taking bisphosphonates for osteoporosis.

Instead, there are several factors, including age, BMD, fracture history, family history, exposure to drugs like corticosteroids, smoking history, alcohol use and activity level, that help doctors determine a person's risk of bone fracture from osteoporosis.

People who are at low risk for fractures may be able to stop using bisphosphonates within five years. People who are at higher risk, however, might be advised to continue using bisphosphonates for up to 10 years. Ask your doctor what risk category you are in and discuss the benefits and risks of long-term bisphosphonate use. Also discuss what other treatment options might be appropriate for you. 

Posted in Osteoporosis on April 22, 2011


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