Q. My sister has been on the osteoporosis drugs Fosamax, Forteo and Reclast during the last ten years. The first of March her leg just gave way and she had a broken femur.
She has also had jaw and teeth problems for the last several years. I think the prescribing doctor has a responsibility to highlight the serious side effects of these drugs.

A. A new study in the New England Journal of Medicine (May 5, 2011) establishes a strong relationship between the use of bisphosphonate drugs for osteoporosis (Actonel, Boniva, Fosamax, Reclast) and atypical fractures of the thigh bone (femur).
Such drugs have also been associated with jaw bone death (Journal of Dental Research, online May 6, 2011). We agree that the prescriber has a responsibility to review all serious complications of such medications, even if they are relatively rare. There is more information on the pros and cons of osteoporosis medicines in our Guide to Osteoporosis.

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  1. Dr James
    Reply

    This is an issue that dentists face when we consider dental implants for older patients. There has been an increase in the use of DEXA scans to accurately gauge bone density for high risk patients.

  2. AR
    Reply

    Aging gracefully! I like that.
    Anyhow, a recent bone density test shows that I moved from osteopenia (2 years ago) to osteoporosis. I refused to have a hormonal treatment back in 2009. I had gone off Fosamax after about 4 years and have come to prefer alternatives and have tried to stay away from synthetic medicine at all cost.
    But now that I have osteoporosis, I am interested in more details about your ‘natural estrogens in patch': dosage? brand name? any generic? a prescription is required to purchase the patch? patches are effective for how long? any side effects? how natural is natural? cost per patch?
    2000 units of vit. D – That sounds like a lot. Prescription is required for that high a dosage? how safe is a high dosage?
    I am 60 this year. Since the diagnosis of osteoporosis, my treatment regimen has included walking (1 km/day), cutting back on coffee some (caffeine, I read, reduces absorption of calcium). I take about 1500 units of calcium + vit. D/boron combined and I have been on a mostly vegetarian diet with some meat intake (sole source of vit. B12) .
    You have been on the patch for 5 years now, with apparently super results supported by scan numbers!
    By the way, anyone has read/taken Strontium non-hormonal treatment of osteoporosis? The little I know so far is that it is available in U.S. over the counter. Main side effect: thrombosis, which is not good. Would also like to hear from those readers who have tried Strontium. Thanks.
    Would appreciate more information. Thanks.

  3. AR
    Reply

    All synthetic medicine are scary to me, including Forteo which was prescribed in injections to my sister for severe osteoporosis. Could you or other readers write more about your experience with Forteo: dosage, any side effects whether minor or major, how long you have taken it, impressions and results supported by bone density tests? Also does it come in other forms?
    Thanks.

  4. S.L.
    Reply

    This is interesting as we are looking for an alternate; although’ I understand the bisphosphonates stay in the body for up to 5 years.
    Would like more detail on what exactly this person is using.

  5. RMC
    Reply

    I had stress fractures and eventually my femur broke Jan. 2011.
    I was taking Fosomax and Actonel for about 5yrs, suppose to strengthen the bones because I also take prednisone. Now I am left with a rod from the top of the hip down to the top of my knee. I was advised to start using Forteo for 18 months a shot each day. I am also on a bone stimulator twice a day.
    Is this safe for me to be doing all of this?

  6. MAW
    Reply

    I’m so glad this discussion is happening concerning drugs vs. alternatives to solving osteoporosis. Bravo! Add in vitamin k as well as d. Calcium cannot be absorbed if you are taking C , but be careful with calcium anyway as there are many reports that it can lead to more problems than cures.
    Eat your calcium through the leafy greens. I eat no red meat and haven’t for years. I also don’t drink milk or consume very much dairy.(except my beloved yogurt) I drink cucumber/yogurt slushy daily. Sorry, may sound bad, but makes my day with a dash of dill.
    I do weight lifting excerises and a lot of cardio as my job is an active one and sometimes just put my leg and arm weights on as I move throughout the day.
    My aunt died because of Osteoporosis and my Mom was well on her way with broken bones before a heart attack took her.
    I had a very, very bad report years ago, took all the doctors prescribed, still went down and then did a fairly vegan diet and am fantastic now
    Good luck to all!

  7. Barbara
    Reply

    Me too!!! I broke my femur in November 2009. Just recently I broke
    a tooth which led to discovering I have “soft bone” in my upper jaw.
    WHAT do manufacturers and sellers do to compensate us for health
    problems resulting from this stuff? I STILL walk up and downstairs
    like a child……………

  8. Aging Gracefully
    Reply

    My doctor highly recommended and pushed Forteo and other bisphosphonates, but I would not take them. I began a regimen of natural estrogens thru patch and/or implants combined with 2,000 units Vitamin D, and my bone scan numbers went up dramatically. The scan results went from osteoporosis to ostopenia to the normal range. This regimen has worked great for the last 5 years.

  9. mmu
    Reply

    It would be more helpful if we knew how long the patient had been on Forteo alone and/or in combination with each of the other drugs mentioned, and whether she used each of them properly; also, the age of the patient, whether she is an active or sedentary person, etc. Too many unknowns in this abstract: More scary than helpful.

  10. MH
    Reply

    I had been on fosomax for 7 years and my doctor did tell me it should, generally, be only taken for about 5 years. My dentist had also warned me about possible problems when I needed a root canal done. I have been off of fosomax for about 6 months now. While I am concerned about osteoporosis, I will follow the doctor’s advice: have bone density tests. weight bearing exercise and calcium supplements (although now there are problems with that – possible link to heart disease? Oh, well . . . )
    Good luck!
    MH

  11. psmith
    Reply

    What is the answer for the millions of people out here who are put on bisphosphonates? I’m in my mid 50’s and am supposed to be on Actonel. I stopped it because it upset my stomach and also hearing all the scary stories. Is there any way to rebuild bone density at my age (I’m not on any hormones)? I have osteopenia.
    PEOPLE’S PHARMACY RESPONSE: YOU MAY FIND OUR GUIDE TO OSTEOPOROSIS HELPFUL. IT OFFERS A NUMBER OF DIFFERENT SORTS OF DRUGS AND NON-DRUG OPTIONS.

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