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Bisphosphonates

• Osteoporosis [hide all summaries]
  Osteoporosis is a reduction in bone mass and weakening of bone architecture that increases the susceptibility of bone to fracture. Bone is a living tissue that is constantly being broken down and resynthesized at 1 to 2 million microscopic sites in the adult skeleton. Osteoporosis occurs when the rate of breakdown is faster than the rate of resynthesis. The history of the treatment or prevention of osteoporosis is strewn with drugs such as estrogens—discussed below—and others in this chapter with marginal effectiveness or with risks clearly outweighing the benefits.

• alendronate (FOSAMAX); risedronate (ACTONEL)

• Dexlansoprazole (KAPIDEX, DEXILANT): The Sixth Proton Pump Inhibitor for Heartburn [hide all summaries]
  (July 2010)
  This sixth drug for treating "heartburn" has no advantage for patients over older drugs such as PREVACID, generic name lansoprazole. Any advantage is for the industry because the manufacturer of DEXILANT charges three times more for this drug than the cost of generic lansoprazole, sold by another company and just as effective for patients.
• Preserving Bones with Bisphosphonates: Should You Avoid NSAIDs? [hide all summaries]
  (July 2010)
  It appears likely that patients who take bisphosphonates (such as FOSAMAX) and NSAIDs at the same time have an increased risk of gastrointestinal ulcers as opposed to taking either drug alone. The article reviews the studies demonstrating this and offers some practical advice on what the cautious drug user should do.
• Long-term Use of Bisphosphonates for Osteoporosis [hide all summaries]
  (January 2009)
  Emerging reports of a rare but unique type of fracture in patients receiving bisphosphonates for many years point toward the drug as a possible culprit. Unlike most drugs, bisphosphonates remain in your body for many years after you stop taking them. Further investigation into the risks, as well as benefits, of long-term bisphosphonate use is needed. But, because there is little evidence of benefit after five years and the long-term risks remain largely unknown, it is reasonable to discuss with your doctor discontinuing these drugs after five years. However, you should continue to take calcium and vitamin D supplements at currently suggested doses (discussed in the article) regardless of whether or not you are on bisphosphonates.
• Osteoporosis Fracture Prevention: What You Need to Know about Drugs and other Measures - Part 2 [hide all summaries]
  (December 2008)
  The article discusses the difference between the benefits of drugs to prevent a first fracture (primary prevention) and to prevent further fractures in people who have already experienced a fracture (secondary prevention). In addition to discussing when it may or may not be appropriate to use drugs such as Fosamax (alendronate) or Actonel (risedronate) the article discusses ways of preventing falls and other non-pharmacologic approaches to preventing fractures.
• A Review of Ibandronate (BONIVA) For Osteoporosis [hide all summaries]
  (October 2006)
  Although this osteoporosis drug has been shown to decrease vertebral fractures, which involve the bones that make up the spine, the drug did not show any decrease in nonvertebral fractures, such as hip fractures, in postmenopausal women. We know more about the older, alternative drugs for osteoporosis.
• Death of Parts of the Jaw Bone With Osteoporosis Drugs Such As Alendronate (FOSAMAX) [hide all summaries]
  (September 2006)
  The typical signs and symptoms of osteonecrosis of the jaw may include pain, swelling or infection of the gums, loosening of the teeth, poor healing of the gums, numbness or a feeling of heaviness in the jaw, drainage and exposed bone. Patients taking a bisphosphonate (including Fosamax) should carefully monitor themselves for any sign of jaw problems resembling those described in this article.
• Zoledronic Acid (ZOMETA) And Pamidronate (AREDIA) Linked to Jaw Bone Damage: Popular Osteoporosis Drugs Also Evaluated [hide all summaries]
  (August 2005)
  The FDA Office of Drug Safety recommended that the professional product labeling for alendronate(Fosamax)and risedronate (Actonel) also be revised to warn of the possibility of osteonecrosis of the jaw (destruction of the jawbone). At this time, the FDA has not taken such action.