Questions about Fosamax, Bisphosphonates and Osteonecrosis of the Jaw

The Bottom Line

• ONJ is most common in patients with cancer who receive frequent intravenous infusions bisphosphonates, but rare in postmenopausal women or men with osteoporosis.


• ONJ may occur during treatment with zoledronic acid (Zometa), pamidronate (Aredia), alendronate, risedronate, and ibandronate, but 94% of cases have occurred with intravenous zoledronic acid or pamidronate.


• Risk factors for ONJ include cancer, frequent infusions of intravenous bisphosphonates, and dentoalveolar trauma or infection.


• Before beginning therapy with oral or intravenous bisphosphonates, patients should be referred for dental care to address dental issues. Bisphosphonate therapy should not be started until dental issues have resolved.

Important: We hope you find this general medical and health information useful, but this Q&A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.