What are Bisphosphonates?
Bisphosphonates are medicines that help strengthen bones and reduce the risk of fractures. Bones are living tissue, constantly broken down and rebuilt. If this balance is lost, bones weaken and break more easily. Bisphosphonates slow down the cells that break down bone, restoring balance and making bones stronger.
These medicines don’t completely take away the risk of breaking a bone, but can significantly reduce it.
Which Bisphosphonates might I be prescribed?
In the UK, bisphosphonates are usually tablets:
- Alendronic acid – take ONCE a week.
- Risedronate – usually once a week, sometimes daily.
- Ibandronic acid – once a month.
How to take Bisphosphonate tablets
- Taken daily, weekly, or monthly depending on prescription.
- Usually first thing in the morning, on an empty stomach, with a full glass of water.
- Wait 30 minutes–2 hours before eating or drinking anything else.
- Stay upright for 30 minutes to avoid irritation of the gullet (oesophagus).
Important considerations
- Missed doses: Follow instructions for daily, weekly, or monthly tablets—never take two on the same day/week.
- Heartburn or swallowing problems: Stop and speak to your doctor.
- Calcium & Vitamin D: Often prescribed alongside bisphosphonates to support bone health.
- Other medicines: Tell your doctor/pharmacist about all medicines you take, as some (e.g. ibuprofen, aspirin) may irritate the gut.
- Dental check-ups: Inform your dentist before and during treatment. Rarely, bisphosphonates can cause bisphosphonate-related osteonecrosis of the jaw (BONJ). Therefore, it is advised to see a dentist to check the health of your jaw and teeth.
Reducing risk of Bisphosphonate related osteonecrosis of the jaw (BONJ)
- Regular dental visits and good oral hygiene.
- Avoid smoking, limit alcohol, and reduce sugary snacks/drinks.
- Tell your dentist about all medicines you take.
- Contact your dentist if you notice jaw pain, swelling, loose teeth, exposed bone, or unusual sensations.
We can also include a link to the NHS site for further information regarding bisphosphonate (alendronic acid) if need be:
NHS information and guidance on Alendronic acid (medicine to treat and prevent osteoporosis)