Bisphosphonates

   If you have bone metastasis or have been on Androgen Deprivation Therapy for any length of time, your Physician may prescribe Bisphosphonates to strengthen your bones and delay onset of osteoporosis.

Bisphosphonates are a class of drugs that prevent the loss of bone density and are used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used to treat osteoporosis. Evidence shows that they reduce the risk of fracture.

Bone tissue undergoes constant rebuilding and is kept balanced by (osteoblast creating bone) and (osteoclasts Destroying bone). Bisphosphonates keep bone matter from being absorbed by encouraging osteoclasts to undergo cell death,  slowing bone loss.

The uses of bisphosphonates include the prevention and treatment of osteoporosis , bone metastasis , and other conditions that cause bone fragility.

Bisphosphonates, when administered intravenously for the treatment of cancer, have been associated with osteonecrosis ( Bone Death ) of  the jaw with most cases occurring following high-dose intravenous administration used for some cancer patients. Some 60% of cases are preceded by a dental surgical procedure (that involves the bone), and it has been suggested that bisphosphonate treatment should be postponed until after any dental work to eliminate potential sites of infection. A number of cases of severe bone, joint, or musculoskeletal pain have also been reported. Common Bisphosphonate names are Pamidronate, Neridronate  Olpadronate  Fosamax Boniva Actonel and Zometa. There are others. 

    How doctors prescribe Bisphosphonates has evolved over time. Standard practice several years ago called for monthly ongoing infusions. It was then discovered that patients received the same benefit if they only received an infusion every 4 months. Recently studied have shown patients should receive Bisphosphonates no more than two years. Longer use can lead to bone softening and fracture risks. It appears that after 2 years the drug has the potential to do more harm than good.

   If  your doctor feels you may need Bisphosphonates, it is important to have a complete Dental Examination to determine if you are in need of any dental work requiring bone involvement. Examples include, extractions, implants, and gum tissue grafts. If you require dental work it is important to have it all work completed prior to starting treatment. Bisphosphonates have a half life of 10 years or so and you cannot have any dental work involving bone until the medication is no longer in your bones.

   Bisphosphonates are a very effective treatment and are well tolerated by most patients. They are effective against osteoporosis and treating bone metastasis by slowing the growth of tumors on the bone.