Bisphosphonate drugs, which are used to reduce bone fractures in patients with osteoporosis, may cause severe and even “incapacitating” musculoskeletal pain, says the US Food and Drug Administration in an alert issued on 7 January.

The pain can occur within days or years after starting treatment, says the agency. Severe musculoskeletal pain is mentioned in the prescribing information for all bisphosphonates, but the agency issued the alert because of “a sizable number of additional reports of severe bone, joint, and/or muscle pain in patients taking a variety of bisphosphonates” since a 2005 report on …