Adverse effects of bisphosphonates: Implications for osteoporosis management

Kurt A. Kennel, Matthew T. Drake

Research output: Contribution to journalReview articlepeer-review

263 Scopus citations


Bisphosphonates are widely prescribed and highly effective at limiting the bone loss that occurs in many disorders characterized by increased osteoclast-mediated bone resorption, including senile osteoporosis in both men and women, glucocorticoid-associated osteoporosis, and malignancies metastatic to bone. Although they are generally well tolerated, potential adverse effects may limit bisphosphonate use in some patients. Optimal use of bisphosphonates for osteoporosis requires adequate calcium and vitamin D intake before and during therapy. The World Health Organization fracture risk assessment algorithm is currently available to determine absolute fracture risk in patients with low bone mass and is a useful tool for clinicians in identifying patients most likely to benefit from pharmacological intervention to limit fracture risk. This fracture risk estimate may facilitate shared decision making, especially when patients are wary of the rare but serious adverse effects that have recently been described for this class of drugs.

Original languageEnglish (US)
Pages (from-to)632-638
Number of pages7
JournalMayo Clinic proceedings
Issue number7
StatePublished - Jul 2009

ASJC Scopus subject areas

  • Medicine(all)


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