Bisphosphonates Cause Rare Eye Inflammation

Sept. 25 -- WEDNESDAY, Sept. 24 (HealthDay News) -- Doctors can now add inflammatory eye disease to the list of potential side effects from the bone medications known as bisphosphonates.

Though exceedingly rare -- only four cases have been reported in the medical literature -- inflammatory eye disease may occur soon after an injection of a bisphosphonate, according to a letter in the Sept. 25 issue of the New England Journal of Medicine (NEJM).

"Physicians should be aware of this rare complication of bisphosphonates," wrote the Australian doctors who authored the letter. "Bisphosphonate infusions should be used with caution, or avoided altogether, in patients with acute ocular inflammation or a history of inflammatory eye disease or uveitis."

Bisphosphonates are medications used to reduce the risk of bone fracture and to increase bone mass in people with osteoporosis, according to the U.S. Food and Drug Administration. They're also used to slow bone turnover in people who have cancer that has spread to their bones, and in people who have a disease called Paget's disease of bone. Bisphosphonates are also used to lower excessive levels of calcium in the blood in some people with cancer, according to the FDA.

Medications included in this class of drugs include alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), tiludronate (Skelid) and zoledronic acid (Reclast, Zometa).

The current NEJM case report focuses on a 57-year-old man who received an infusion of zoledronic acid to treat bone loss in his knee. The other three cases of eye inflammatory disease occurred in people who had receive infusions of pamidronate, according to the report.

All four reported cases were treated with corticosteroids and improved in days.

Not all potential side effects of bisphosphonates resolve so quickly, however. One of the most serious complications arising from the use of these medications is osteonecrosis of the jaw (ONJ). Symptoms of ONJ include pain, exposed bone and loosening of the teeth, according to the American Dental Association. The risk of ONJ, which is also a rare complication, is increased when people on bisphosphonates have invasive dental procedures. If you're taking a bisphosphonate, be sure to let your dentist know about it before you have any extensive dental work done.