Bisphosphonates, such as alendronic acid, risedronate, and ibandronate, are effective in reducing the risk of fractures in osteoporosis. Studies show that they significantly reduce fracture risk, especially within the first three to five years of use. However, after five years, the benefits of continuing these medications become minimal, while the risk of potential side effects, such as unusual fractures of the thigh bone (atypical femoral fractures), may increase.
Based on current recommendations from the rheumatology department, we advise stopping bisphosphonate therapy after five years, unless there is a specific reason to continue. For those who have a low risk of fractures and no history of previous fractures, stopping treatment after three years may be considered.
If you have completed five years of bisphosphonate therapy, we recommend discontinuing the medication. You may continue taking calcium and vitamin D supplements if required. If you sustain a low-trauma fracture after stopping treatment, alternative therapies such as denosumab or PTH injections may be considered.
Additionally, routine bone density scans (DXA scans) after stopping bisphosphonates are not typically necessary, as bone density measurements alone do not indicate the need for further treatment. Instead, we encourage focusing on overall bone health, including a balanced diet, regular weight-bearing exercise, and fall prevention strategies.
If you have any concerns about stopping your bisphosphonate medication, please book an appointment to discuss your individual treatment plan.