Including:

Use: These drugs are prescription medications used for osteoporosis treatment in women after menopause. Their primary mode of action is to block certain hormone pathways and prevent the resorption of bone. Bones in people who use bisphosphonates appear denser on scans.

Side Effects: These drugs may cause: pain or trouble swallowing (dysphagia), heartburn (esophagitis), ulcers in your stomach or esophagus (the tube that connects your mouth and stomach).

Common side effects include: diarrhea, pain in extremities (arms or legs), dyspepsia (upset stomach). Less common side effects are short-lasting, mild flu-like symptoms (usually improve after the first dose). Patients have reported severe bone, joint, and/or muscle pain starting within one day to several months after beginning to take, by mouth, bisphosphonate drugs to treat osteoporosis (thin bones). Most patients experienced relief from side effects after stopping the drug. Contact your healthcare provider if you develop these symptoms after starting bisphosphonates.

Rarely, patients taking bisphosphonates have reported serious jaw problems associated with delayed healing and infection, often following dental procedures such as tooth extraction. If you experience jaw problems, please contact your healthcare provider and dentist.

Precautions: There are concerns that long-term bisphosphonate use can result in severe or over-suppression of bone turnover especially at the femur region. It is thought that micro-cracks in the bone are unable to heal and eventually unite resulting in atypical fractures. Such fractures tend to heal poorly.

Bisphosphonates have been associated with osteonecrosis of the jaw.  

Directions: Take by mouth. To lower the chance of heartburn, you should always take first thing in the morning — at least 1 hour (60 minutes) before eating or drinking anything except plain water, and before taking any other oral medicines or supplements. Take this drug while standing or sitting in an upright position, and then do not lie down for at least 60 minutes after swallowing.

You should swallow it whole with 6 to 8 ounces (1 cup) of plain water (not mineral or sparkling water, coffee, tea, dairy drinks or juice). Some mineral waters may have a higher concentration of calcium and therefore should not be used

Keep out of reach of children and pets