The New Once –A-Year-Osteoporosis Drug Osteoporosis or literally "soft bone" is the disease everybody is concerned with for obvious reasons. We expect a surge in the elderly population over next 15 years and with the increasing geriatric population we expect more osteoporotic related issues i.e. fractures. There is tremendous development occurring in the drugs available for treating osteoporosis. I am going to discuss one such drug today and it is called "Zolendronic Acid". There is a group of drugs called bisphosphonates which are widely used in treating osteoporosis. These drugs coat the bones and make them harder so that they do not break. Initially these drugs were given on a daily basis. They improved and we started using them on once a week basis. They further improved and we started giving them once a month. Zoledronic acid is one such drug but the beauty is that it can be given once a year! The oral tablets which discussed had another disadvantage. They had to be taken first thing in the morning on an empty stomach and the patient was advised not to eat anything or sleep for 30 minutes. Many patients developed acidity and long term gastritis because of these drugs. Patients also had to remember the date on which they were specified to take the drug. The result was quite a few dropped out. These drop outs then faced a major risk of fractures. Zolendronic acid is not a new drug. It was used to treat pain due to cancer spreading to the bones for a long long time. Recently a higher (5mg) dose was approved for the prevention of osteoporosis. This drug is given once a year intravenously. The drug was not very popular because of the cost involved i.e. INR 18,000 for one. The monthly tablets used to coast around 2000 INR. For 12 months! This year a lot of Indian companies have introduced this drug literally at a throw away price! The cost of one annual injection is now 2100 INR! So the cost is similar to the annual tablet budget but the convenience is great. All the patients complaining about the acidity issues can relax because the drug is injected and not swallowed! It takes 30 minutes to inject this drug and any nursing home or a day care clinic can do the job easily. Are there any risk factors or side effects? There are 2 common side effects with these drugs. Many patients get body ache for 2 days similar to the pain we feel during a flu attack. Fortunately this resolves on taking paracetamol tablets. Some patients actually get fever for 24 to 36 hours and gain it responds to paracetamol. There are other side effects mentioned on the leaflet accompanying the drug but they are very rarely observed. We do tell the patient to drink plenty of water before the injection which reduces the body aches significantly. Over all it is a very beneficial drug for patents undergoing anti osteoporotic treatment. So if your doctor orders one please go ahead. For more information consult your local orthopedic surgeon or write to Dr. Shreedhar Archik on drarchik@yahoo.com