Bisphosphonates and severe musculoskeletal pain

admin January 8th, 2008

The FDA have issued advice about bisphosphonates and severe musculoskeletal pain.

The severe musculoskeletal pain may occur within days, months, or years after starting a bisphosphonate. Some patients have reported complete relief of symptoms after discontinuing the bisphosphonate, whereas others have reported slow or incomplete resolution. The risk factors for and incidence of severe musculoskeletal pain associated with bisphosphonates are unknown.

This severe musculoskeletal pain is in contrast to the acute phase response characterized by fever, chills, bone pain, myalgias, and arthralgias that sometimes accompanies initial administration of intravenous bisphosphonates and may occur with initial exposure to once-weekly or once-monthly doses of oral bisphosphonates. The symptoms related to the acute phase response tend to resolve within several days with continued drug use.

Bottom line: Patients who present with severe musculoskeletal pain who are taking bisphophonates may benefit from a temporary or permanent cessation of therapy.

  • FDA
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