Hi. Can you advise please? Ive been offered the choice between having my bisphosphonates orally or intravenously. I initially opted for the infusion as I’m forgetful with pills and had heard that the tablets cause upset stomachs. But my dentist said the infusion is more likely to cause the jaw necrosis. I’m not sure which to choose. My dentist is happy with my teeth. I see my oncologist on monday.
Thank you
I asked for the tablets but my oncologist wont prescribe them. Insists on me having infusion as said that research shows its more effective (unsure which research she is referring to).
Said that tablets were given out during covid but no evidence to suggest its as effective
Excellent youre being given a choice.
Maybe ask about the effectiveness of both as well as aide affects to support your decision.
Good luck
I had bisphosphonates infusion and for me, it wasn’t a pleasant experience.
Everyone i guess is different and they say you have flu like symptoms for 3 days. I was ill for 3 weeks, so just be cautious that you may or not be ill. Just to prepare you.
I have Lupus, so that might have contributed to my extended reaction to the drug.
I didn’t have tablets because of gastro issues.
In short, there isn’t any way to say which version is best. You can only try and see unfortunately.
Good luck.
Hi bluesatsuma,
I chose to have the infusions as i had already been prescribed alot of medications to help prevent reoccurrence. The thought of having to take another tablet was hard for me. Ive gone from taking one tablet a day pre cancer diagnosis, to now taking 9 tablets a day. I had my second infusion last week. My body does not seem to like them very much, but i can cope with a few days of not feeling great. As its only once every 6 months i have it. Do what you feel is best for you. Good luck with whichever option you choose x
Hi @bluesatsuma i chose the infusions over tablets. The risk of jaw necrosis is very low, my dentist wasn’t too concerned. I didnt like the idea of taking another tablet each day especially with all its restrictions and side effects, such as taking an hour before food and sitting still and upright during that time and then the possibility of having to take another tablet such as Omeprazole to counteract the side effects. I’ve had two infusions so far, they take about 15 minutes. After the first i was a bit achey for about 24 hours and after the second no symptoms at all apart from maybe slightly more tired than usual for a couple of days, although its difficult to say if it was that that caused it. Yes its worth discussing which is more effective and going through side effects with oncologist when you see them. st
Penny
Hi
I didn’t have a choice I was prescribed the tablets. Even though I stuck with the instructions I had nausea every day until lunchtime. My Oncologist changed this to IV infusions of Zometa every 6 months supposedly for 3 years but this was reduced to 2 after research showed 2 years was as effective as 3.
I must be one of the lucky ones as I had no side effects at all and it was a relief that I only had to go once every 6 months.
I consulted my dentist who said the risk of necrotic jaw disease was very low and mainly in those with poor dental health, however changed my appointments to 6 monthly and prescribed a fluoride toothpaste. I was also advised not to have any extractions if possible during treatment.
I’m happy yo say my treatment is completed and I have had no issues with my jaw.
I hope whichever you choose you do well, best wishes
Dear @bluesatsuma, I was offered Ibandronate when I declined the Zometa infusion on the basis that if I had a bad reaction I would only have a weeks worth of drug in me and not 6 months worth. ( I have a long history of adverse reactions to medication). However, Ibandonate only came as a tablet and as I cannot swallow tablets there were no other options. The oncologist said the alternative biphosphonate that comes as a liquid ( Alendronate) had no prevention of recurrence properties. She said that as my benefit of biphosphonates on Predict was so low then it would make little difference statistically if I took nothing. I did consult my GP about the Alendronate, especially as I have osteopenia, but he said he wouldnt prescribe because of the side effects. Love Tulip x
I have the ibandronic acid tablets. I am in a routine with them now. Most mornings I sit and read, I sometimes do some stretching, I have been known to have a little nap. Once a week I go for a run.
The tablets I take say to wait at least half an hour before having food. I rarely have any noticeable problems with indigestion. I occasionally have a day or two off if it doesn’t fit with my plans (say on holiday or something), but always take the calcium tablet.
Hi @bluesatsuma
I have had 1 infusion so far and can honestly say it did not affect me at all. I asked my dentist about jaw necrosis and he was not concerned. There can be an issue if you need an extraction but regular check ups at the dentist should prevent it. My dentist told me I have very good teeth. I too now have low bone density and am now on prescription vitamin D and calcium tablets. I had my Herceptin injection at the same time as my infusion and it was absolutely fine.
I’m having my 9th infusion on Friday- last one will be end of November. I’ve had no side effects at all (except for a pleasing 2% increase in bone density). My dentist said it’s about 1in 100,000 (not sure how accurate that is!).
Like @pennyp i would be anxious about taking tablets.
I had to have a back tooth out over a year ago as it was cracked. I was worried but it was absolutely fine.
Good luck with whatever you decide.
I’ve been on the pills (1, once a week for three years now) and it’s been a good choice for me.
I changed to infusions after about 2 months on tablets. I did this because they totally interfered with my lifestyle - I ended up waking up at 4am every single day to take it at 6am to do all the necessary be upright, don’t eat or drink etc. before my 7am swim.
So much easier to manage with my 6-monthly hospital trips - 45ish minutes in the chair + bloods time. I’m close to my hospital so used to nip in for bloods the day before.
Re your dentist saying ‘more likely’ - it’s a very rare side effect, so more likely of a tiny number is still a tiny risk.
When I spoke to my oncologist about changing from tablets to infusions, she said that the infusions go directly to your bones where the tablets take a while and only part of the dose reaches them. This was in response to me asking why tablets are daily and infusions are every six months. I suppose that also explains why you can feel a little bit achy after you first couple of infusions.
Choose what’s right for you.
Hi bluesatsuma
I take Alendronic acid tablets
I did ask for the dissolvable tabs at first but they were awlful as they repeated on me and made me nauseous.
I now take the tab once a week and sit still for 30 mins and then have breakfast.
I do suffer from IBS and occasionally they cause a bit of cramping later in the day and sometimes make me a little dizzy but I have tolerated them now for almost 2 years.
Hope that helps
Best wishes
Lynn x
Hi bluesatsuma
Thanks for posting.
As you can read from all the responses to your question, there are lots of reasons why people may choose how they receive their treatment with bisphosphonates for early breast cancer. In the end the decision you make is an individual one, but its important you have all the information you need to help you do this.
As you’re seeing your oncologist on Monday, it would be a good idea to write down all of your concerns and questions and discuss them fully, along with the side effects of the treatment, before making your mind up.
Although there are many who’ve replied to your post, you might still want to be in touch with others who’ve made this decision, which you can do through our Someone Like Me service or in other areas of the forum.
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