Considerations regarding osteoporosis medications

Oral bisphosphonates
Preferred because of safety, low cost, and lack of evidence of superior antifracture benefits from other osteoporosis medications
Avoid in patients with gastroesophageal reflux disease or esophagitis
Intravenous bisphosphonates
Higher risk with intravenous infusion (than with oral bisphosphonate therapy) of hypersensitivity reaction, acute-phase reaction (influenza-like illness), hypocalcemia
Longer half-life
Consider for better adherence, given no weekly pill burden
Expensive; burden of therapy with daily injections
Limited to 2 years of therapy
Caution in patients with urolithiasis
Lack of safety data in premenopausal women
Hypersensitivity reaction, infection risk
  • Based on information in reference 9.