Aasis Unnanuntana, MD; Anas Saleh, MD; Kofi A. Mensah, MD, PhD

John P. Kleimeyer, BA; Joseph M. Lane, MD

Extract
Bisphosphonates are the most commonly prescribed type of medication for the treatment of osteoporosis. Studies have shown that bisphosphonates reduce the incidence of vertebral and nonvertebral fractures when used to treat postmenopausal osteoporosis1-4. The indications for use of bisphosphonates also extend to other metabolic bone diseases such as glucocorticoid-induced osteoporosis, Paget disease, hypercalcemia due to a variety of causes, and skeletal metastases5-7. Treatment with bisphosphonates, however, is not without adverse effects. Because bisphosphonates act by inhibiting osteoclast function and inducing osteoclast apoptosis8,9, there is a substantial concern regarding the potential side effects related to severe suppression of the bone turnover rate.