Drug holiday effect on osteoporosis: a narrative review of the current literature

Abstract

Abstract Bisphosphonates are most common drugs used in the treatment of osteoporosis being effective in reducing fracture risk. Although these drugs are quite safe and tolerable drugs, there has been an association with severe adverse effects after a prolonged period of use. The idea of ‘drug holiday’ is becoming a trend, because of the way these drugs work, absorbed by the bone and continuing the exertion of an antiresorptive effect even after discontinuation, meaning that the patient continues to benefit from anti-fracture efficacy, while the risk of side effects is reduced. Discontinuation of bisphosphonates should be considered in patients who have been treated for more than 5 years with alendronate or more than 3 years with risedronate or zoledronic acid, and reassessment should be done every 1 to 3 years if there is no new adverse event in the meantime.