BISPHOSPHONATES

Information in this fact sheet is meant to assist you in making decisions about your treatment. Always make medication decisions in consultation with your healthcare team.


What are Bisphosphonates used for?

Bisphosphonates are a family of drugs used to treat secondary cancer in the bones (also known as bone metastases).

Bisphosphonates work by slowing down bone re-absorption, which allows the bone forming cells time to rebuild normal bone. This allows bone remodelling to go back to normal and protects the bones from being weakened. The main reason these drugs are administered is to minimise skeletal-related events (which can include bone pain, spinal cord compression, fracture, and need for surgery or radiation).

Ask your doctor if you have any questions about why this medicine has been prescribed for you. Bisphosphonates is available only with a doctor's prescription and can only be given by a doctor or a nurse.


What do bisphosphonates look like?

Bisphosphonates come as a solution for infusion.


How are bisphosphonates given?

Bisphosphonates will be given to you by infusion directly into a vein by a doctor or nurse. A 100 mL infusion will take at least 15 minutes.


What are the common side effects?

Side effects of bisphosphonates may include pains in the muscles and joints, and low levels of calcium in the blood. Some people experience flulike symptoms, which usually settle after the first dose. Oral bisphosphonates (taken by mouth) may also cause indigestion and a sore throat or inflamed gullet.

Your doctor will probably advise you to take calcium and vitamin D supplements to prevent a low level of calcium in the blood and to strengthen your bones while you are taking bisphosphonates.

Contact your doctor if you experience pain, weakness or discomfort in your thigh, hip or groin as this may be an early indication of a possible fracture of the thigh bone.


What are the less common side effects?

Tell your doctor and dentist immediately about any dental symptoms you get after you have bisphosphonate drugs. This may include pain in the mouth, teeth and jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, or loosening of a tooth. These could be signs of bone damage in the jaw (osteonecrosis).

Tell your doctor immediately or go to an Emergency Department at your nearest hospital if you notice any of the following after you have bisphosphonates:

  • signs of allergy such as a rash, itching or hives on the skin; swelling of the face, lips, tongue or other part of the body
  • shortness of breath
  • signs that the level of calcium in your blood may have fallen too far, such as muscle spasms
  • numbness or tingling sensation, especially around the mouth
  • shortness of breath
  • signs that your kidneys may not be working properly, such as decreased urine output.

The above side effects may be serious. You may need urgent medical attention.

Tell your doctor, nurse or pharmacist if you notice anything that is making you feel unwell.


References

Macmillan 2012, Bisphosphonates, Macmillan Cancer Support 1st December 2102, viewed 9th July 2013.

TGA Consumer Medical Information (CMI) 2013, ACLASTA®, Therapeutic Goods Administration April 2013, Canberra, viewed 4 th July 2013.


Disclaimer

Prostate Cancer Foundation of Australia develops materials based on best available evidence and takes advice from recognised experts in the field in developing such resource; however it cannot guarantee and assumes no legal responsibility for the currency or completeness of the information.