American Board of Family Medicine (ABFM) Practice Exam 2025 - Free ABFM Practice Questions and Study Guide

Hypocalcemia is a well-known complication that can occur as a result of bisphosphonate use. Bisphosphonates are primarily used to treat osteoporosis and other conditions that lead to bone loss by inhibiting osteoclast-mediated bone resorption. While they are effective for increasing bone mineral density and reducing the risk of fractures, they can also interfere with calcium metabolism.

The mechanism behind hypocalcemia in patients treated with bisphosphonates is largely related to the decrease in bone turnover. As the drug inhibits the activity of osteoclasts, which are responsible for the resorption of bone matrix and release of calcium into the bloodstream, there may be a resultant drop in serum calcium levels, especially if dietary intake or vitamin D status is not adequate.

In some cases, particularly if bisphosphonates are administered intravenously or in higher doses, the risk of hypocalcemia increases. This is particularly relevant in patients with existing conditions that may affect calcium homeostasis, such as vitamin D deficiency or impaired renal function.

In contrast, hypertension, diabetes mellitus, and chronic pain syndrome are not typically associated with bisphosphonate use. While there may be anecdotal reports linking chronic pain to bisphosphonates, it is not