On Monday, the US Food and Drug Administration reminded to healthcare professionals of the possibility of severe and sometimes incapacitating bone, joint, and/or muscle pain in patients taking bisphosphonates.

Bisphosphonates is a class of drugs that inhibits osteoclast action and the resorption of bone and they are used in the treatment of osteoporosis.

Bisphosphonates are sold under commercial names such as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa.

Osteporosis is a bone disease in which the the bone mineral density is reduced and is common for women after the menopause. The patients with osteoporosis present high risk of fractures, mostly involving the lumbar vertebrae, hip, and wrist.

Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics.

The FDA said that is still unknown why in some cases bisphosphonates may produce musculoskeletal pain.

Also, the FDA explained that the healthcare professionals should differentiate the musculoskeltal pain induced by bisphosphonates from bone pain that sometimes occur in the early phases of the treatment with these drugs.

In the early stages of exposure to bisphosphonates, patients may also report fever and chills, but the symptoms tend to resolve within several days with continued drug use.