Osteoporosisconnection.com, the site you’re currently visiting, contains an intricate jigsaw of posts by visitors, posts by expert patients and doctors, and reader questions with answers. And the vast majority of this content is devoted to one subject: osteoporosis drugs.
Do I need to take a drug? Does it have to be a bisphosphonate? If so, which one? Why Fosamax? Why Boniva? How about Forteo? Is Miacalcin better?
For the past year or so, I’ve been facing (and trying to avoid) this same issue. Though my T-scores have been drifting ever downward, I’ve put off taking drugs to combat this bone loss. And this, despite a past that includes chemotherapy and years of hormone drugs. What’s up with that?
Maybe it’s the horror stories I’ve heard about bisphosphonates, the most effective osteoporosis drugs. They give you gastritis. They can kill bone in your jaw and leave you with an open wound. The way you have to take them is so fussy…
Or maybe it’s the fact I just plain don’t want to pop another pill every day. Or even once a week. You know, it just gets old. That 7-day pill container is an unwelcome albatross around my neck, a reminder that I’m not the healthy person I once was.
But the time for waffling, hesitation, and foot-dragging is over. It’s time to face facts: I need to take a drug to slow down bone loss. If I don’t, I could suffer a life-altering fracture. Soon.
So I’m going to start taking Actonel.
Why Actonel (a.k.a. risendronate)? Because online research done while writing posts on this site leads me to believe that this particular bisphosphonate, rather than Fosamax or Boniva, is the right osteoporosis prevention drug for me.
And if you’re a post-menopausal breast cancer survivor who’s undergone chemo, and/or is currently taking an aromatase inhibitor—a group that’s growing by leaps and bounds—here’s why Actonel may be right for you, too.
•A University of Pittsburgh study, outlined last June in the Journal of Clinical Oncology, indicates that Actonel works particularly well for post-menopausal women who’ve undergone chemotherapy for breast cancer; as well as for women taking an aromatase inhibitor to prevent a cancer recurrence. This study didn’t examine Fosamax and Boniva; only Actonel.
I’ve done chemo; I take Arimidex (an AI). The University of Pittsburgh study says Actonel will slow my bone loss. Score one for Actonel.
•Dr. Neil Gonter, expert physician on this site, cites results of the FACT trial (Fosamax Actonel Comparison Trial) showing that Fosamax outperformed Actonel by a small margin. Women taking Fosamax showed marginally fewer markers related to bone loss.
However, Dr. Gonter warned that this small difference doesn’t necessarily translate into fewer bone fractures. And the trial also showed that Actonel begins showing results within about a year, while Fosamax takes about 2 years to kick in.
I’ll trade Actonel’s faster action for Fosamax’s slightly better results. Score another one for Actonel.
•Unlike Fosamax or Boniva, the other common bisphosphonates, Actonel increases bone density throughout the skeleton. It’s been shown to reduce the risk of spinal fractures and hip fractures, as well as wrist, pelvis, clavicle, leg, and humerus fractures, all within the first year of treatment.
Why would I choose a bisphosphonate that only works on my spine, or only on my hips, when Actonel improves bone mineral density all over my body? Actonel wins again.
So what’s the down side? Like all bisphosphonates, Actonel needs to be taken in a fairly regimented fashion: with 8 ounces of plain water, while remaining upright for 30 minutes afterwards, and with no food. There’s a chance, particularly if you don’t follow the instructions, that you could experience some fairly severe heartburn and other gastrointestinal issues. Again, same as Fosamax and Boniva.
Actonel breaks away from competitors Fosamax and Boniva, however, with the addition of joint and back pain to the list of side effects. This might affect your choice, depending on your level of pain tolerance. But if you’re taking an AI, you probably already experience joint pain. So what’s a bit more, right?
Is Actonel right for you? How about Fosamax? Boniva? There comes a time when you simply have to step off the cliff, choose one, and see what happens.
For me, that time has come.
How about you? If you’re still considering options, read our bisphosphonate comparison. Maybe it’ll help you take the next step.
Published On: February 13, 2009