Bisphosphonate counselling

Question 1

Check for contraindications

Answer 1

• Pregnancy
• Dysphagia/ abnormalities of oesophagus
• Recent peptic ulcer
• Significant renal impairment
• Unable to sit upright for 30 minutes

Question 2

How the treatment works

Answer 2

• Prevents bone from being broken down and helps to rebuild new bone
• Remember lifestyle factors can also help with this, such as exercise, not smoking (we can help) and eating a well-balanced diet

Question 3

Treatment course and how it’s taken

Answer 3

• Once daily or once weekly tablet
• Swallow tablet with full glass of water
• Take at least 30 minutes before food or anything other than water
• Be upright for 30 minutes after swallowing
• Taken long term
• Monitoring required
• Regular dental check-ups (risk of osteonecrosis of jaw)

Question 4

Side effects

Answer 4

• Headache
• Heartburn, bloating, indigestion
• GI (diarrhoea/ constipation, abdominal pain)
• Seek urgent medical advice if symptoms of = Osteonecrosis of the jaw, dysphagia/odynophagia, upper GI bleeding/ black stools