Risks of medications
All medications have potential side effects. Some are more serious but rare, some are less serious but more common. Below are examples of both common and rare side effects for some osteoporosis medications.
- Gastrointestinal Issues: irritation to the lining of the stomach leading to stomach upset, indigestion, inflammation of the esophagus, nausea, abdominal pain, diarrhea, constipation, and heartburn (gastroesophageal reflux).
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Skin Reactions: rash, light sensitivity, itchiness, or swelling
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Flu-like Symptoms: 2-3 days of mild fever, body aches, headaches and malaise, similar to the flu. This is typically only associated with the first dose of medications.
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Hot Flashes: a sudden, intense feeling of warmth in the upper body, which is most intense over the face, neck and chest. Your skin might redden as if you’re blushing and you may begin sweating. Hot flashes may be accompanied by rapid heartbeat, headache, weakness, dizziness, and anxiety.
- Osteonecrosis of the Jaw: This is a very rare occurrence that may increase with longer exposure to certain osteoporosis medicines. It refers to the long-term presence (>2 months) of a non-healing bone ulcer in the mouth that causes pain, swelling, or infection in the jaw. Experts estimate that only 1 out of 100,000 people taking certain osteoporosis medications may experience this side effect. Invasive dental procedures, such as tooth extractions, increase this risk, but it can occur spontaneously as well. Other known risk factors include diagnosis of cancer in patients also receiving chemotherapy or steroids.
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Atypical Femoral Fracture: This is a rare type of broken thigh bone from minimal to no trauma that can cause pain in the thigh or groin that begins subtly and gradually worsens over weeks to months, similar to a stress fracture. It can occur in both legs at once. This is also a very rare side effect, though risk may increase with longer exposure to certain osteoporosis medications. Experts estimate that only 2 out of 100,000 people with osteoporosis may experience this side effect after two years on a bisphosphonate. In particular, Asian women tend to be at a higher risk of an atypical femoral fracture when taking an osteoporosis medicine. If not identified early on, a complete fracture of the femur (thigh bone) requiring surgery can even occur with normal weight-bearing activities.
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Cardiovascular Events: This side effect includes events such as a heart attack (myocardial infarction) or blood clots in the legs or lungs (venous thromboembolism), requiring medical treatment at a hospital.