(Date: September 2017. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

Quick read

Bisphosphonates are not usually recommended in pregnancy as there is not enough evidence to say that they are safe for the baby.

What are they?

Bisphosphonates (alendronic acid, ibandronic acid, pamidronate disodium, risedronate sodium, sodium clodronate and zoledronic acid) are used to prevent weakening of the bones. They are used to treat bone conditions like osteoporosis and bone pain caused by cancer.

What are the benefits of using a bisphosphonate in pregnancy?

Bisphosphonates treat bone loss and bone pain. This can mean that you are more mobile and in less pain. However, they are not generally recommended in pregnancy as there is little information about how they might affect the unborn baby.

What are the risks of using a bisphosphonate in pregnancy?

Bisphosphonates are stored in bone and are thought to stay in the body for up to ten years. In theory, this means that a pregnancy occurring several years after bisphosphonate use could be exposed.

The risks are largely unknown. Only around 100 women taking bisphosphonates either before or during pregnancy have been studied. While bisphosphonates did not cause ill-effects in their babies, further research is required to make sure.

Are there any alternatives to using a bisphosphonate in pregnancy?

Switching drugs or stopping treatment may be an option. If you are planning a pregnancy, or become pregnant during or after bisphosphonate therapy, you should discuss options with your doctor.

What if I prefer not to take a bisphosphonate during pregnancy?

Stopping a bisphosphonate may be an option if advised by a doctor.

Medicines will only be prescribed during pregnancy when necessary and a doctor will be happy to talk to you about any concerns.

Will I or my baby need extra monitoring?

As part of routine antenatal care, most women will be offered a detailed scan at around 20 weeks of pregnancy to check the baby’s development. Extra monitoring for major birth defects is not usually required. As the effects of bisphosphonates are largely unknown, some doctors might advise additional checks of the baby’s growth and wellbeing.

There have been a small number of reports of babies exposed in the womb to bisphosphonates having low calcium levels. The baby’s calcium level may therefore be checked after delivery with a blood test.

Are there any risks to my baby if the father has used a bisphosphonate ?

There is no evidence that a bisphosphonate used by the father can harm the baby through effects on the sperm.

Who can I talk to if I have questions?

If you have any questions about the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit to register.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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