Drug holiday
What it means
A drug holiday is a temporary, prescriber-guided pause from a bisphosphonate medication after several years of use, since the drug's effects on bone can last even after stopping.
Understanding drug holidays helps you have an informed conversation with your prescriber about balancing long-term bone protection with rare medication risks.
A drug holiday is a planned pause from taking a bisphosphonate medication (like Fosamax, Actonel, or Reclast) after a period of regular use. Because these drugs stay in bone tissue for a long time, their protective effect can continue even after you stop taking them for a while.
Guidelines discuss this pause after roughly 3 to 5 years for many patients, mainly because the rare risks linked to long-duration use, such as osteonecrosis of the jaw and atypical femoral fracture, become more of a concern the longer someone stays on the medication. The idea is to balance the real fracture-protection benefits against these uncommon but serious tradeoffs.
Whether and when a drug holiday makes sense, and for how long, depends on your individual history, bone density, and risk factors. This is a conversation to have with your prescriber, who can weigh your specific situation, rather than a decision to make on your own.
How sure is this?
Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.
Where the Academy teaches it
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Questions people ask about this
Stopping Prolia (denosumab) isn't a neutral event. Because it doesn't build up in your bones the way bisphosphonates do, its protective effect wears off once doses stop. This can lead to a rapid rebound in bone turnover and a risk of multiple vertebral fractures, sometimes within months — so this is a decision to make with your prescriber, not on your own.
Read the full answer →Related words
Bisphosphonates are osteoporosis medications — like alendronate, risedronate, and zoledronic acid — that slow down…
Osteonecrosis of the jaw (ONJ) is a rare condition where part of the jawbone loses blood supply and fails to heal,…
An atypical femoral fracture is an uncommon break in the shaft of the thigh bone that looks and behaves differently…
Antiresorptive medications, like bisphosphonates and denosumab, slow down the cells that break down old bone,…
Osteoclasts are the cells that break down old bone tissue, working alongside bone-building osteoblasts to constantly…
Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.
