Which serious risk is associated with bisphosphonate therapy?

• A. Osteonecrosis of the jaw
• B. Hypertension
• C. Hyperkalemia
• D. Weight gain

Answer: (A)

Bisphosphonates suppress osteoclast activity to slow bone loss, but that same effect slows bone remodeling and healing in the jaw, which undergoes frequent stress from chewing and dental procedures. When healing is impaired, exposed bone can become infected and die, leading to osteonecrosis of the jaw. This is a serious, sometimes persistent condition that can be difficult to treat and may necessitate stopping the drug or dental interventions. The risk is higher with potent IV forms used in cancer and with long-term use, as well as with invasive dental work, poor oral health, steroids, and other risk factors. In contrast, hypertension, hyperkalemia, and weight gain are not characteristic risks of bisphosphonate therapy.