Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. It also increases your risk for spine and hip fractures. These fractures can be disabling and make it hard for you to live on your own.

Your bones naturally get thinner as you age, making them more likely to break. But whether you take medicine or not, healthy habits can protect your bones and prevent bone loss. Take calcium and vitamin D supplements. Get regular weight-bearing exercise, and cut back on alcohol. If you smoke, quit.

Bisphosphonates are the most common medicines used to prevent bone loss in people who have osteoporosis. They slow the way bone dissolves and is absorbed by your body. They can increase bone thickness and strength.

They include:

• Alendronate (Fosamax).
• Ibandronate (Boniva).
• Risedronate (Actonel or Atelvia).
• Zoledronic acid (Reclast).

Bisphosphonates aren't right for everyone. Depending on your health, your doctor may suggest other medicines to help prevent bone loss. Your doctor may also suggest these other medicines if you are having a problem with side effects from bisphosphonates.

Other medicines include:

• Raloxifene (Evista).
• Calcitonin (Fortical or Miacalcin).
• Teriparatide (Forteo).
• Denosumab (Prolia).
• Hormone replacement therapy (HRT) or estrogen replacement therapy (ERT).

Women who have gone through menopause can take bisphosphonates instead of hormone replacement therapy for osteoporosis. But bisphosphonates won't help with menopause symptoms.

Studies show that bisphosphonates increase bone thickness and lower the risk of fractures.¹

Most of these medicines should be taken in the morning with a full glass of water at least 30 minutes before eating a meal, drinking a beverage, or taking any other medicine. If your doctor prescribes the form of risedronate called Atelvia, take it right after breakfast with a glass of water.

Zoledronic acid is injected into a vein in your arm. Most people who use it get just one dose each year. One form of ibandronate is also given in a vein, usually every 3 months.

If you have osteoporosis, you should also take calcium and vitamin D supplements. Take them at least 2 hours before or after you take these medicines.

If you take the medicines as prescribed, side effects are not common. But they can include:

• Heartburn, belly pain, irritation of the esophagus, and trouble swallowing if your bisphosphonates are taken by mouth. The esophagus is the tube that connects the throat to the stomach.
• Headache and pain in muscles and joints.
• Constipation, diarrhea, and passing gas.
• Allergic reactions.

If you start taking these medicines and have problems with side effects, you can try other medicines. Talk with your doctor.

Your doctor may want you to have a follow-up bone mineral density (BMD) test after you have been on treatment. If this is suggested for you, it will be done no more than every 2 years. Getting follow-up tests doesn't make your treatment work better.

Your doctor may suggest that you take bisphosphonates if:

• You have abnormal bone loss for your age.
• You have osteoporosis, osteopenia, or risk factors for osteoporosis.
• You have been taking hormone replacement therapy and stopped.