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Deprescribing

Bisphosphonate Review

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Long-term treatment with bisphosphonates may increase bone fragility by suppressing normal bone remodelling — a process essential for repair of skeletal micro-damage. Atypical femoral fractures have been reported (rarely) with bisphosphonate therapy, mainly in patients receiving long-term treatment for osteoporosis.
 
The need for continued treatment should be re-evaluated periodically based on the benefits and potential risks of bisphohe need for continued treatment should be re-evaluated periodically based on the benefits and potential risks of bisphosphonate therapy for individual patients, particularly after 5 or more years of use.’
 
Because the effects of bisphosphonates lasts for several years after the bisphosphonate has been stopped, it is reasonable to consider a treatment break (‘drug holiday’).
 
Some useful resources can be found here:

  Management Newsletter Special Supplement  - Prescribing for Osteoporosis