REVIEW - Bisphosphonate-associated adverse events

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Hormones (Athens). 2009 Apr-Jun;8(2):96-110.

Bisphosphonate-associated adverse events.

Papapetrou PD.

Second Division of Endocrinology, andra Hospital, Athens, Greece.

The adverse events of the nitrogen-containing bisphosphonates are

reviewed. Oral bisphosphonates (alendronate, risedronate and

ibandronate), mainly used for the treatment of osteoporosis, have been

associated with adverse events from the upper gastrointestinal tract,

acute phase response, hypocalcaemia and secondary hyperparathyroidism,

musculoskeletal pain, osteonecrosis of the jaw and ocular events.

Intravenous bisphosphonates (pamidronate, ibandronate and zoledronic

acid), used in oncology and for the treatment of osteoporosis, have

been associated with all the above adverse events, except those from

the upper gastrointestinal tract. Moreover, pamidronate and zoledronic

acid have been associated with renal toxicity. Association of

bisphosphonates with atrial fibrillation and atypical fractures of the

femoral diaphysis remains uncertain. There are a few case reports

relating bisphosphonates to cutaneous reactions, oral ulcerations,

hepatitis and esophageal cancer. Generally, intravenous are more

potent than oral bisphosphonates and the frequency and severity of

some of the bisphosphonate- associated adverse events are dose and

potency dependent.

PMID: 19570737

http://www.ncbi.nlm.nih.gov/pubmed/19570737

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