Which of the following are common adverse effects and risks associated with bisphosphonates?

• A. Hypertension, tachycardia
• B. GI irritation and esophagitis
• C. Hyperglycemia
• D. Photosensitivity

Answer: (B)

GI irritation and esophagitis are the most common adverse effects seen with bisphosphonates, especially the oral forms. These drugs can irritate the lining of the esophagus as a tablet travels down, which is why proper administration is crucial: take with a full glass of water and stay upright for at least 30 minutes after taking the dose to keep the medication from lingering in the esophagus. If esophageal irritation occurs, symptoms like heartburn, chest pain, or trouble swallowing may appear, and the clinician may adjust therapy or switch to an alternative route or agent.

Other listed effects don’t match the typical safety profile of bisphosphonates. Hypertension and tachycardia aren’t characteristic adverse effects of these drugs, hyperglycemia isn’t expected with them, and photosensitivity isn’t a known risk. It’s useful to remember that while GI irritation is most common, longer-term use can bring other concerns such as osteonecrosis of the jaw, atypical femoral fractures, and hypocalcemia if calcium and vitamin D are not adequately present in the body.