Are They Effective? A government study found “insufficient scientific evidence to establish whether bisphosphonates are better at preventing fractures than estrogen, calcitonin, or raloxifene.” The good news is that the study suggests that people with osteoporosis have many effective treatment options – bisphosphonate drugs are just one of them. 

Bottom Line: If you need medication to prevent or treat osteoporosis, you have several effective options. You and your doctor will need to decide which one is best for you.

Who should take bisphosphonates? The recommendations are still evolving. Traditionally, doctors have treated based largely on fracture history and T-scores – a measure of bone density. Dr. Saag notes that new recommendations from the World Health Organization will be based on a combination of risk factors for fracture, including age, sex, race, corticosteroid use and history of inflammatory disease.

Regardless of their risk factors, people who cannot sit upright for at least 30 minutes after taking oral medication, and those with esophageal ulcers or severe kidney impairment, clearly should not take them, Dr. Saag says.