Lifestyle modifications, Vitamin D, and calcium supplements are the first and best line of defense against osteoporosis. This is because all osteoporosis prescription drugs come with side effects, some of which are quite serious. Side effects of bisphosphonates for example are esophageal ulcers, esophageal inflammation, nausea, stomach pain, and difficulty swallowing. These risks can be minimized by taking bisphosphonate injections rather than pills.

Longterm use of bisphosphonates has been associated with thigh bone fractures. This is a rare outcome and happens only if a patient has been on the drug for five years or longer. Another unusual, but documented side effect is the deterioration and death of part of the jaw bone following tooth extraction. This condition is called osteonecrosis.

Osteoporosis patients should bear in mind that when prescribing a medication, a doctor has weighed the risks against the benefits and determined that the benefits significantly outweigh the risks. Many patients will start on one type of osteoporosis medication and then be switched to another to keep longer term side effects in check.