AB249. SOH25_AB_347. Oral ulceration associated with alendronate administration

Background: Oral bisphosphonates are commonly used in the treatment of osteoporosis, particularly in post-menopausal women. Their mechanism of action involves increasing bone density by inhibiting osteoclast-mediated bone resorption and facilitating osteoblastic effectiveness. Although they are generally well tolerated, oral bisphosphonates come with potential adverse effects including, gastroesophageal reflux, fever-like symptoms, oesophagitis and peptic ulceration. A less well-known side effect of the drugs is oral ulceration associated with the administration of, in this case, alendronate. There are sixteen cases currently reported, this case looks at a 63-year-old lady who presented to our clinic following an urgent referral from her general practitioner regarding a non-healing ulcer on the dorsum of the tongue. The patient reported that this ulcer had been present for 4 months, increasing in size and causing great difficulty on eating. Following discussion of the patient’s medical history, the patient reports administration of alendronate (70 mg) to the dorsum of the tongue once a week. Extraordinarily, there was no cervical lymphadenopathy. Intraorally, ulceration measuring approximately 1.5 cm was noted on the dorsum of the tongue.

Methods: The patient, following on from initial consultation, was instructed to cease administration to the site for four weeks.

Results: Marked improvement of the ulceration was noted in a one month follow-up.

Conclusions: Therefore, a conclusion could be drawn that there is a correlation between incorrect administration of alendronate and chemical ulceration.

Keywords: Alendronate; bisphosphonates; chemical; oral; ulceration