Patient and carer information for bisphosphonates
Bisphosphonates are medicines used to treat and prevent bone disorders. They work by slowing down the cells that break down bone, helping to reduce bone loss. They can also help lower high calcium levels. Several types of bisphosphonates can be given through a drip (intravenously), and each type works in a slightly different way.
- Sodium Clodronate
- Ibandronate (Bondronat, Bonviva)
- Disodium Pamidronate (Aredia)
- Zoledronic Acid (Aclasta, Zometa)
Your doctor and bone health specialist nurse will discuss which is the best treatment for you.
How it is administered
Bisphosphonates are given intravenously (IV). A small tube called a cannula is placed into a blood vessel and the drug – diluted in a bag of normal saline – is connected to the cannula. The infusion takes between 15-90 minutes, depending on which drug you have been prescribed.
You will need to attend an outpatient clinic for your treatment. You will need a blood test prior to treatment to check your kidney function and make sure you are able to start treatment. You can eat, drink and take your usual prescribed medicines as normal.
It is recommended that you are well hydrated (have drunk plenty of fluids) before your treatment. The bone health nurse may also give you a drug prescription chart to bring to clinic.
You will be at the clinic for about an hour. During your visit, the IV nurse will check your blood pressure, pulse, breathing, oxygen levels and temperature. You may be asked to stay a little longer so your observations can be checked again. It is important to let the nurse know if you have any allergies.
If you think you may be pregnant, you must tell the nurse before your treatment. Your medical practitioner will also request a blood test after your treatment.
Side effects are very rare once you are home. However, if you feel unwell, contact your GP, call 111, or 999 in an emergency.
Side effects
Like all medicines, bisphosphonates can cause side effects – although not everyone gets them. The chance of reactions usually decreases with further doses of bisphosphonate therapy.
Most side effects happen within the first three days following bisphosphonate therapy. These may include myalgia (muscle pain), arthralgia (joint pain) and headaches.
Some people may get flu‑like symptoms or a mild fever lasting up to 48 hours. Fever normally settles on its own without treatment.
A very rare side effect of this treatment is osteonecrosis of the jaw, which can happen if you take bisphosphonates for more than a year.
Osteonecrosis means death of bone tissue and the exact cause is unknown. Symptoms can include pain, swelling, gum infections, loose teeth, and numbness or heaviness in the jaw. If the bone health specialist nurse referred you, they will give you further information.
It is recommended that you stay well‑hydrated before starting treatment. Have a dental check‑up if needed and always tell your dentist you are having bisphosphonate therapy. You should also tell your doctor if you need dental treatment.
If you are concerned about side effects, speak with your doctor, the bone health specialist nurse, or a member of the IV therapy team. It is important you tell the nurse of any side effects you may be experiencing.
Clinic specific information
Please ensure your transport home is arranged for the end of your treatment (the nurse will advise you of the time). Please note, the clinic opening hours are 8.30am – 4.30pm.
Free parking is available in the small car park at the rear of the Churchdown Clinic building, or on the main road outside the front. The clinic is next to The Brambles Veterinary Surgery.
If you are unable to attend or have any questions about your appointment, contact the Community IV Therapy Team on 0300 421 8195. If you need to contact the team on the day of your appointment, call 0300 421 8207.
To help prevent infection, please wash your hands or use hand gel while visiting the clinic, and do not attend if you have cold or flu‑like symptoms.
If you receive certain benefits, you may be able to claim a refund of reasonable travel costs under the NHS Healthcare Travel Costs Scheme (HTCS). More information can be found at www.ghc.nhs.uk/travel-costs, or you can contact us prior to your appointment.
Please be aware, NHS treatment is not free for everyone. You may be asked to provide additional evidence with regard your UK residency status for non‑emergency care.