Why Doctors Still Prescribe Fosamax

Fosamax is used for both the treatment and prevention of osteoporosis – most often in post-menopausal women. Proponents of the medication cite that those who take Fosamax are less likely to suffer hip fractures along with fractures of the spine that are the result of compressed vertebrae. Ultimately, the reason that a physician is going to prescribe Fosamax is simple: the goal is to maintain bone mass in those who are at the greatest risk for developing osteoporosis.

Overall, the incidence of serious complications from Fosamax is relatively low.

Should I Take Fosamax?

If your doctor suggests that you start taking Fosamax, you should take the time to ask questions. Be sure that you are talking with your doctor about other medications that you take – including over the counter antacids and NSAID pain relievers (including aspirin and ibuprofen). In some cases, your physician will be able to answer questions that you have that will help you feel better about taking the medication; in other cases, your doctor will look at alternative treatment options.

I Already Take Fosamax. Should I Stop?

If you already take Fosamax, do not stop taking the medication without talking with your doctor; if you have concerns about the medication or find that you are experiencing some of the more severe side effects associated with taking Fosamax, you should call your doctor immediately as he or she will be in the best position to provide the answers that you need. While your doctor may agree that stopping Fosamax is in your best interest, your care giver is the best person to make decisions regarding your care.

Common Side Effects

The most common side effects associated with Fosamax are:

• stomach pain
• constipation
• nausea

Within the warnings from Merck are also the more serious side effects to be aware of:

• jaw pain
• muscle or bone pain
• black stools
• vomit that looks like coffee grounds
• new and worsening heartburn
• ulcers of the esophagus
• difficulty or pain when swallowing
• symptoms of an allergic reaction: rash, itching, swelling, trouble breathing

Because of these warnings, patients who have been on corticosteroids, hormone replacements treatments and anti-inflammatory medications – including over the counter ibuprofen – need to be sure that they are discussing these other medications that they take.

American Association of Endodonists Warning

The AAE has come forward to discuss additional warnings that should be made about the use of Fosamax. The American Association of Endodontists were among the first to come out with a specific warning about Fosamax and osteonecrosis of the jaw. In a statement issued in March of 2006, the AAE said:

“The AAE is at the forefront of this emerging complication because endodontists have special expertise in finding the cause of oral and facial pain that has been difficult to diagnose,” said AAE President Marc Balson, D.D.S. “With this position statement, we hope to ensure the highest quality care and safety for patients taking bisphosphonates.”

“Until further information becomes available, the AAE recommends that all patients taking bisphosphonates be considered at some risk for ONJ, recognizing that the magnitude of the risk varies by patient,” he added. “The AAE also encourages patients taking bisphosphonates to inform their dental care providers and consult with specialists as needed.”

This relationship between Fosamax and osteonecrosis of the jaw has also been cited by the US Food and Drug Administration (FDA) and the Health Sciences Authority. It is a warning that is similar to that released by Novartis Oncology about the use of injectable biphosphate medications similar in structure to Fosamax.