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Case Report | Medicine | Volume 15 Issue 7, July 2026 | Pages: 1773 - 1776 | United States
Prolonged Musculoskeletal Toxicity Following Inadvertent Concurrent Alendronate and Zoledronic Acid Therapy with Sustained Improvement in Bone Mineral Density: A Case Report
Abstract: This case describes a woman in her 70s who experienced prolonged musculoskeletal toxicity following unintentional overlap in bisphosphonate therapy with alendronate and zoledronic acid. On initial presentation, she reported chronic, severe myalgias and fatigue, of greater than six months duration, following a single 5 mg zoledronic acid infusion while concurrently taking 35 mg of alendronate once weekly. One of the most common adverse effects reported for both drugs is musculoskeletal (muscle, joint, and bone) pain, more so for zoledronic acid than alendronate. The degree of severity and duration in this patient raises questions regarding a possible acute phase reaction to zoledronic acid infusion and the impact of concurrent use of two bisphosphonates. Serial dual-energy x-ray absorptiometry (DEXA) scans demonstrated an increase in bone mineral density (BMD) up to two years after bisphosphonate therapy termination. This unique case highlights the importance of careful medication reconciliation during transitions between bisphosphonate therapies to prevent severe adverse reactions while demonstrating the prolonged therapeutic effects of bisphosphonates on bone mineral density.
Keywords: Osteoporosis, Alendronate, Zoledronic acid, Bisphosphonates, Medication error, Acute phase reaction, Musculoskeletal toxicity, Bone mineral density, DEXA
How to Cite?: Mehreen Tai, Caitlyn Loveridge, Dr. Alicia King, "Prolonged Musculoskeletal Toxicity Following Inadvertent Concurrent Alendronate and Zoledronic Acid Therapy with Sustained Improvement in Bone Mineral Density: A Case Report", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 1773-1776, https://www.ijsr.net/getabstract.php?paperid=SR26717071538, DOI: https://dx.doi.org/10.21275/SR26717071538