Why are bisphosphonates used in breast cancer?
In breast cancer, bisphosphonates are used primarily to reduce bone loss (osteoporosis) and the risk of fracture among postmenopausal women with estrogen receptor-positive disease who receive aromatase inhibitors.
Are bisphosphonates worth taking?
If you are at a higher risk of having a fracture, taking bisphosphonates is more likely to help you prevent a fracture. If your risk of a fracture is lower, it’s less likely that these medicines will help you. Your doctor might use the FRAX tool to help predict your risk of a fracture.
What cancers are treated with bisphosphonates?
Bisphosphonate treatment can stop some types of cancer from spreading into the bone for some people. Studies have also shown that bisphosphonates can help some people with breast cancer and myeloma to live longer. Bisphosphonates might also help to: prevent or control bone thinning (osteoporosis)
When should you not take bisphosphonates?
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.
Is bisphosphonates a chemotherapy?
The use of bisphosphonates to prevent bone metastases remains experimental. Last, bisphosphonates in addition to chemotherapy are superior to chemotherapy alone in patients with stages II and III multiple myeloma and can reduce the skeletal morbidity rate by approximately one half.
Can bisphosphonates cause cancer?
Our findings indicate that bisphosphonates do not appear to increase cancer risk. Although reductions in breast and colorectal cancer incidence were observed in bisphosphonate users it is unclear, particularly for breast cancer, to what extent confounding by low bone density may explain the association.
Who should not take bisphosphonates?
Don’t take bisphosphonates if you:
- Are allergic to them.
- Have disorders of the food pipe (esophagus), including tears, holes, narrowing, or difficulty swallowing.
- Have severe kidney disease.
- Can’t sit in an upright position for at least 30 minutes.
- Have low levels of calcium in your bloodstream.
What happens when you stop taking bisphosphonates?
When treatment is stopped, if there is continued presence of bisphosphonate in bone and continued release (and possible re-attachment to bone), there might be some lingering antifracture effect after treatment is stopped.
What are the two medications that may cause osteoporosis after long term use?
The medications most commonly associated with osteoporosis include phenytoin, phenobarbital, carbamazepine, and primidone. These antiepileptic drugs (AEDs) are all potent inducers of CYP-450 isoenzymes.
Are bisphosphonates safe?
Bisphosphonates are generally well tolerated and safe. Nevertheless, adverse events have been noted, and it is important to consider the strength of the evidence for causal relationships. Effects on the gastrointestinal tract and kidney function are well recognized, as are transient acute-phase reactions.
How long does it take for bisphosphonates to work?
How quickly do bisphosphonates work? It takes several months for bisphosphonates to work. Usually there is an increase in bone density 6-12 months after you start taking one. This then helps to prevent breaks (fractures) of the spine, the hip, and other bones such as the wrist.
When should I start taking bisphosphonates?
If a patient is not already treated, pharmacologic therapy (typically bisphosphonates) should be initiated in patients with fragility fracture to prevent subsequent fracture . (See “Overview of the management of osteoporosis in postmenopausal women”, section on ‘Candidates for therapy’.)