Common Oral<unk> s can cause upset stomach and inflammation and erosions of the esophagus, which is the main problem of oral N-containing preparations. This can be prevented by remaining seated upright for 30 to 60 minutes after taking the medication. Intravenous<unk> s can give fever and flu-like symptoms after the first infusion, which is thought to occur because of their potential to activate human γδ T cells.<unk> s, when administered intravenously for the treatment of cancer, have been associated with osteonecrosis of the jaw (ONJ), with the mandible twice as frequently affected as the maxilla and most cases occurring following high-dose intravenous administration used for some cancer patients. Some 60% of cases are preceded by a dental surgical procedure (that involves the bone), and it has been suggested that<unk>  treatment should be postponed until after any dental work to eliminate potential sites of infection (the use of antibiotics may otherwise be indicated prior to any surgery). A number of cases of severe bone, joint, or musculoskeletal pain have been reported, prompting labeling changes. Some studies have identified<unk>  use as a risk factor for atrial fibrillation (AF), though meta-analysis of them finds conflicting reports. , the US Food and Drug Administration did not recommend any alteration in prescribing of<unk> s based on AF concerns. More recent meta-analyses have found strong correlations between<unk>  use and development of AF, especially when administered intravenously, but that a significantly increased risk of AF that required hospitalization did not have an attendant increased risk of stroke or cardiovascular mortality. Long-term risks In large studies, women taking<unk> s for osteoporosis have had unusual fractures <unk>  fractures") in the femur (thigh bone) in the shaft (diaphysis or sub-trochanteric region) of the bone, rather than at the femoral neck, which is the most common site of fracture. However, these fractures are rare (12 in 14,195 women) compared to the common hip fractures (272 in 14,195 women), and the overall reduction in hip fractures caused by<unk>  is more than the increase in unusual shaft fractures. There are concerns that long-term<unk>  use can result in over-suppression of bone turnover. It is hypothesized that micro-cracks in the bone are unable to heal and eventually unite and propagate, resulting in atypical fractures. Such fractures tend to heal poorly and often require some form of bone stimulation, for example bone grafting as a secondary procedure. This complication is not common, and the benefit of overall fracture reduction still holds. In cases where there is concern of such fractures occurring, teriparatide is potentially a good alternative because it does not cause as much damage as a<unk>  does by suppressing bone turnover. Three meta analyses have evaluated whether<unk>  use is associated with an increased risk of esophageal cancer. Two studies concluded that there was no evidence of increased risk.
Bisphosphonate
Phosphate binder
Pamidronic acid
Etidronic acid
Sulfonylurea
Allopurinol
Risedronic acid
Alendronic acid