Bisphosphonates are drugs that are used to help strengthen and reduce the risk of fractures in bones that have been weakened by metastatic breast cancer. Examples include pamidronate (Aredia) and zoledronic acid (Zometa). They are given intravenously (IV).
Bisphosphonates may also help against bone thinning (osteoporosis) that can result from treatment with aromatase inhibitors or from early menopause as a side effect of chemotherapy. There are a number of medicines, including some oral forms of bisphosphonates, to treat the loss of bone strength that is not caused by breast cancer in the bone.Bisphosphonates can have side effects, including flu-like symptoms and bone pain. A rare but very distressing side effect of intravenous bisphosphonates is damage (osteonecrosis) in the jaw bones (ONJ). It can be triggered by having a tooth extraction (removal) while getting treated with the bisphosphonate. ONJ often appears as an open sore in the jaw that won't heal. It can lead to loss of teeth or infections of the jaw bone. Doctors don't know why this happens or how to treat it, other than to stop the bisphosphonates. Maintaining good oral hygiene by flossing, brushing, making sure that dentures fit properly, and having regular dental checkups may help prevent this. Some cancer doctors recommend that before they start taking a bisphosphonate, patients have a dental checkup and have any tooth or jaw problems treated.