Osteoporosis: How long must I take bisphosphonates?

Date Updated: 07/10/2021

Answer Section

Bisphosphonates, the most common type of osteoporosis medications, are typically taken for at least 3 to 5 years. After that, your doctor will consider your risk factors in determining whether you should continue to take these or other osteoporosis medications.

Examples of bisphosphonates include:

Alendronate (Binosto, Fosamax)
Ibandronate (Boniva)
Risedronate (Actonel, Atelvia)
Zoledronic acid (Reclast, Zometa)

These drugs help strengthen bones and prevent fractures. The most common sites for osteoporosis fractures are the wrist, hip and spine. A broken hip can result in a severe decline in quality of life and even increases the risk of death.

Rarely, bisphosphonates may cause:

Osteonecrosis of the jaw. This bone disease features pain, swelling or infection in the jaw. This occurs most commonly after invasive dental procedures, such as tooth extractions.
Thighbone fractures. Long-term bisphosphonate therapy has been linked to a rare type of thigh fracture. This injury, known as atypical femoral fracture, is similar to a stress fracture, causing pain that begins subtly and can gradually worsen. If not identified early on, a complete fracture of the thighbone can occur.

To reduce the risk of these rare complications, your doctor may recommend that you temporarily stop taking bisphosphonates after 3 to 5 years. This is sometimes called a bisphosphonate holiday. People who have severe osteoporosis may need to wait for 10 years before they stop taking these drugs.

A bisphosphonate holiday typically lasts at least a year, but it may last indefinitely for some people if the risks of treatment outweigh the benefits. Luckily, the bone-strengthening effects of bisphosphonates appear to continue for several years after people stop taking the drugs.