Bisphosphonates for postmenopausal osteoporosis

► Bisphosphonates reverse the key pathophysiological changes of postmenopausal osteoporosis. ► The bisphosphonates that have been licensed in many countries for postmenopausal osteoporosis include alendronate, ibandronate, risedronate and zoledronic acid. ► These bisphosphonates all reduce the level of bone turnover and increase the bone mineral density in postmenopausal osteoporosis. ► The bisphosphonates differ in their potency in their effects on bone turnover and bone density. ► The licensed bisphosphonates have all been shown to reduce the risk of vertebral fractures; some of them have also been shown to reduce the risk of non-vertebral and hip fractures.