Doctors' Answers to "Frequently Asked Questions" - Fosamax

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Fosamax [posted 1/13/99]
Question: I am trying to find information on this prescription medication, i.e., applications, side effects, etc.

Answer: Check the FAQ section. Fosamax is a drug, which is used to improve bone density. It is poorly absorbed and is best taken on an empty stomach with water. Major side effects are GI, nausea, esophageal ulcers, gastritis, etc. It works pretty well if it gets absorbed. If not, it is pretty worthless. GI problems are the limiting factor in most patients. In addition to osteoporosis, we use it to treat Paget's Disease.

Fosamax [posted 1/8/99]
Question: I am suffering mouth pain and bleeding gums after taking fosamax. The tablet was taken as directed. Do you know of fosamax causing any mouth problems?

Answer: No.

Fosamax [posted 1/7/99]
Question: I am 60 years old and have been on Fosamax for 6 months now. I have not changed my diet or activities, but gained 15 pounds and get a bloated feeling a lot. Could this be a result of Fosamax? I take Fosamax due to the results of my bone density test and a couple fractures over the past year.

Answer: Bloating yes, weight gain no.

Fosamax & Metallic Taste    [posted 12/02/98]
Question: I have been taking Fosamax for a few weeks and have noticed a very metallic taste in my mouth in addition to experiencing a sort of "sick" feeling. Is a metallic taste a known side effect of this drug? Thank you for any information you can give me.

Answer:  Not usually, but, stop if for a week and see.

Fosamax & Difficulty Walking   [posted 11/17/98]
Question: My mother has been taking fosamax 10 mg. for the last 2 months. She has been complaining of severe hip/leg pain. She is only 56 years old and finds it difficult to get up/walk and drive. Her doctor has not taken any x-rays. I am very concerned. She said that this is one of the side effects of fosamax. She was doing better before she started taking this medication. Should she stop? Thanks for you help.

Answer: Not the fosamax, either arthritis of the hip or possibly a microfracture(the reason she is on the fosamax), either would need xrays and/or bone scan. Another possibility is bursitis of the hip. See a rheumatologist.

Fosamax & Gum Irritation [posted 11/6/98]
Question: I tried taking Fosamax, with no problem until the 4th day. My mouth began to ache like an absessed tooth and my gums began to bleed. The spot it ached the most was in an area where there was NO tooth, just a bridge. I stopped the drug, my mouth improved. I started the drug again, same thing, and painful! I quit again, called my dentist, he wanted to see me. I went today. He looked at the redness in the gum areas, especially where there was no tooth. He called the School of Dentistry and made an appointment for me to get a smear tomorrow. Have you heard of this happening before? I took the medicine as directed. 30 minutes before meals, sitting or standing, with lots & lots of water.

Answer: Esophageal and gastric irritation yes, oral no unless you keep it in your mouth a long period of time.

Take Fosamax With Water [posted 10/15/98]
Question: I have been taking Fosamax since it first came out and it has proved very beneficial to me as indicated by recent bone density test. I am 59 years old and take it in the morning on an empty stomach and have nothing else until 30 minutes have passed. I have been taking it with a large glass of sparkling spring water with lemon such as Poland Spring makes. Is this OK or must it be plain water with no flavoring or any carbonation to it?

Answer: They suggest just plain water. But, if your bone densities are improving, it is getting absorbed. The reason to take it on an empty stomach with only H20 is to enhance absorption(only about 10% of the drug is usually absorbed.)

Fosamax [posted 7/22/98]
Question: I recently saw ads promoting the drug Fosamax, but I'm not sure if this is generic name or brand. Is it an aide to persons with osteoarthritis or joint problems? Does it aide in the reversal of pain, swelling symptoms?

Answer: Fosamax is to treat osteoporosis, not osteoarthritis. Occasional patients with severe osteoporosis (thin bones) will have pain that the Fosamax will help. However, it will have little effect on joints or osteoarthritis.

Fosamax [posted 7/22/98]
Question: I am in urgent need of information regarding the drug Fosamax. I need to know the longest term study to date testing this drug, any long term side effects to date, and any known experimental problems with the testing of Fosamax.

Answer: You'll need to contact the company to get the latest research, especially unpublished data. The company is Merck 800-672-6372.

Fosamax
Question: I have been given Fosamax for my bone density (I have had seven stress fractures this year). I am a distance runner, 16 year old male, and I was wondering if Fosamax could affect my height (my epiphyses are open at the moment)? Is it okay to take Fosamax with a low-joule drink such as Diet Coke or is it best to stick with the water?

Answer: Why do you have osteoporosis? This is very unusual in one your age. I'd get this looked into prior to taking Fosamax. Having said that, it shouldn't affect your growth (but it’s never tested in children and teen-agers). Take it with water if you want to achieve maximum absorption. You need to see an osteoporosis specialist!

Fosamax and Palidronate
Question: Is there any benefit in taking these drugs for a person with osteogenesis imperfecta?

Answer: Not known. Probably not.

Fosamax
Question: My doctor sent me to a specialist who prescribed Fosamax about a year ago because I have an unexpectedly low bone density (determined by a bone scan, I believe it's called.) I am a 53 year old female. I have found the restrictions about taking Fosamax (no food several hours before, none for thirty minutes afterwards, no laying down for thirty minutes afterwards) difficult to follow because my life is so frenetic I am often up during the night, and therefore eating, etc. So I stopped taking it, since my understanding was that it would not be effective unless I met the various food conditions, plus laying down would cause esophageal irritation. I went back to the specialist for a checkup about a week ago, and my bone density had dropped again significantly during the year. I determined to try to take Fosamax again. However, now I am wondering if I could take it late in the afternoons instead of first thing in the mornings. Late in the afternoon I usually meet all the no food conditions, and would not be laying down for some time. I was also wondering if I had to take it at pretty much the same time each day, or if the morning one day, the afternoon the next, etc., would be okay, as a function of when I've been working and therefore eating.

Answer: As long as you take it on an empty stomach, with no other medications or food, it doesn't seem to matter when you take it. Many of my patients prefer late afternoon-- an hour or so before dinner.

Fosamax
Question: My 70 year old mother was put on Fosamax, and after a short time developed one of the side effects - an irritation in her esophagus. She stopped the drug, but now, three months later she is just as uncomfortable. She has seen three doctors and two gastrointerolists who say that there is nothing wrong with her. How long can this irritation last? What can she do to help with the discomfort for now?

Answer: Has she received any treatment? Usually H2 blockers(available over the counter) or treatment with prilosec or prevacid is initially prescribed. If this is unsuccessful, propulsid a motility agent) is commonly added. Possibly it is not her esophagus, but referred pain from her gall bladder or stomach. I would try treating with 300 mg of Zantac for a while and see what happens.

Fosamax
Question: My grandmother broke her lower spinal about a year ago. There is a drug called "Alendronate." I was asked to check out to see if it would help. In addition, what drugs can she take to help her heal faster and ease her pain?

Answer: Fosamax (alendronate sodium) is a recently released medication to aid in osteoporosis. Its function is to specifically inhibit the resorption of bone. The initial studies of this drug are promising since it is one of the few "non hormonal" drugs to achieve any improvement in bone density. These initial studies show about a 1 to 2% improvement in bone density for the first three years of the study. The most common currently published side effects are abdominal and skeletal pain, nausea, constipation and headache. Markedly severe side effects have not been noticed-a word of caution here-the time duration of this drug is currently relatively short and other drugs have found severe side effects when used with larger population groups for longer periods of time. I have about 75 to 100 females on this drug with relatively low side effects. I really haven't seen the 5% of side effects noted on initial trials. I also caution all my patients that this is a relatively effective: but, untested long term drug. Also, when a female breaks a bone I always suggest several studies to ensure that there is no preventable cause of the fracture. These include Vitamin D levels, Parathyroid levels, and testing for excess proteins with a protein electrophoresis. If these have not been performed you should discuss them with your grandmother's physician.



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