Fosamax and Osteonecrosis: How Does it Affect You?
  Contributed by: Kunj Patel, Pharm.D.
                        Community Pharmacy Resident

Fosamax (alendronate) is a very popular drug that has been used to prevent osteoporosis in men and women.  Since 2003 there have been reports of possible links to Fosamax and osteonecrosis (death of the bone because of decreased supply of blood to the bone).  According to recent news, how does this affect those currently taking Fosamax?


What is Fosamax?
Fosamax (alendronate) belongs to a drug class called bisphosphonates.  Other bisphosphonates include Boniva (ibandronate) and Actonel (risedronate). Bisphosphonates are used in patients with osteoporosis, which is a disease that makes bones weak and prone to fractures. 


How does Fosamax work?
Fosamax (alendronate) works by reducing the activity of the cells

that causes bone loss.  By doing so, alendronate decreases the chances of bone fractures.  Those with any abnormalities in their esophagus, inability to stand or sit upright for 30 minutes, and very low levels of calcium should not take alendronate.


What did the research show?
The research showed that the majority of cases of osteonecrosis involved the jaw and occurred in patients with cancer who were receiving chemotherapy.  These patients were receiving bisphosphonates through IV for cancer that had spread to the bones.  A smaller number of cases involved patients that were taking Fosamax for osteoporosis and had ongoing dental disease or were involved in a dental procedure. 


What does this mean for those currently taking Fosamax?
If you are currently taking Fosamax, do not discontinue taking your medication until you have consulted with your doctor.  Keep in mind that the chance for osteonecrosis is not high for those that do not have cancer or dental disease. 

For more information, talk to your doctor or pharmacist.