Biphosphanates information

Biphosphonates are a class of drugs that inhibits the resorption of bone. Biphosphanates are used for the prevention and treatment of osteoporosis, osteitis deformans ("Paget's disease of bone"), bone metastasis, multiple myeloma and other conditions that involve bone fragility. In the last 10 years, millions of patients have taken biphosphanates for the prevention of osteoporosis. Biphosphantes once seemed safe and may have been helpful for patients with cancer or osteoporosis. But, at what risk?
 

Biphosphanate Side Effects
The potential side effects of biphosphanates began in 2003 with a letter in The Journal of Oral Maxillofacial Surgery calling osteonecrosis of the jaw "a growing epidemic." Its author, Dr. Robert E. Marx, chief of oral and maxillofacial surgery at the University of Miami, reported on 36 patients who had received intravenous bisphosphanates. All had "painful bone exposure," as is typical with the condition, and "were unresponsive to surgical or medical treatments."
     Many women have been taking biphosphanates thinking that these drugs were safe. However, there may be a risk for  osteonecrosis of the jaw. Osteonecrosis of the jaw is an uncommon complication, but it is estimated that among the 500,000 American cancer patients who take the drugs because their disease is affecting their bones, 1 to 10 percent may develop the problem. Some dentists are refusing to treat patients taking the drugs, fearful that the dental work will induce a case of osteonecrosis, and lawyers are lining up to sue the drugs' makers, saying they failed to give patients adequate warning.
     Even if patients stop taking the bisphosphanate drugs, they are not free of them. Bisphosphanates remain in bone for years, and no one knows how long the osteonecrosis risk remains. Some doctors and dentists suggest stopping the drugs for a few months before and after an invasive dental procedure. Others say six months to a year may be better.

Bisphosphanates and Cancer
Cancer patients, mostly those with multiple myeloma and breast cancer whose disease has spread to their bones, generally take one of two bisphosphonates, Zometa or the older Aredia, intravenously.

Bisphosphanates and Osteoporosis
Osteoporosis patients usually take bisphosphonates as pills, in much lower doses that patients with cancer. Those biphosphanate drugs — Fosamax, Actonel and Boniva — reduce the risk of fractures of the spine or hip, injuries that can create a steady downward spiral in patients' condition.