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Osteoporosis

Long-term Use of Fosomax

05/15/2006

Question:

I`ve started hearing and reading about dire effects of long term usuage of Fosomax. Is there a better treatment for osteopenia?

Answer:

Treating osteopenia should be based on how severe the osteopenia is.  If the T-score is better than -2.0, a person may not need to be on medication.  However, if a person has a T-score of -2.0 or perhaps -1.5 plus other risk factors for osteoporosis and fracture, it may be appropriate to take medication.

The recently reported complication associated with bisphosphonates is osteonecrosis of the jaw.  It is a very rare complication that appears to be primarily in patients who have cancer and are receiving the drugs intravenously instead of orally.  Healthy people are at very low risk of encountering this complication.  To be prudent, one could discontinue the medication prior to major jaw/dental procedures and resume taking it after the area is well-healed.

Another prescription option for osteopenia is raloxifene, a selective estrogen receptor modulator.  It reduces fractures and appears to reduce the risk of breast cancer as well.  Side effects are similar to those of oral contraceptives and hormone therapy:  blood clots in the legs/lungs.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati