The bisphosphonates are a group of drugs used to reduce bone turnover in conditions including osteoporosis, Paget’s disease, and bone malignancies. The therapeutic effect is achieved by inhibiting bone resorption.  

As a group the bisphosphonates are generally well tolerated, but have a well documented adverse effect (AE) profile, and gastrointestinal effects are a known issue. Strict administration requirements have been introduced to reduce the risk of oesophageal AEs, and inability to meet these requirements is considered a contraindication to treatment.  There have been reports of pain, nausea, vomiting and gastric ulcers associated with bisphosphonate use.