The latest news linking osteoporosis drug Fosamax - also known by its generic name alendronate - with atrial heart fibrillation in some patients serves as an important reminder: Everything we put in our body can change our body.
While prescription medications can provide significant benefits to bone mass and help prevent fractures, they can also cause unexpected side effects, especially in patients with certain preexisting conditions.
Here is an overview of commonly prescribed osteoporosis drugs and potential problems for those who take them.
Bisphosphonates: This family of drugs, which includes Fosamax, Actonel, Boniva and Reclast, share certain concerns in common. These medications should not be taken by anyone who has poor kidney function or low blood calcium.
Some patients experience severe muscle, joint or bone pain while taking bisphosphonates. Patients who experience such symptoms while on any of these medicines should report musculoskeletal pain to their doctor immediately and discuss whether they should discontinue taking the drug.
Bisphosphonates have also been associated with osteonecrosis of the jaw, a painful condition in which the mouth is unable to heal normally, especially after oral surgery. This problem is rare for those who take the drug at the doses normally given to treat osteoporosis (as opposed to patients who have cancer and certain other diseases). The risk of osteonecrosis is considered particularly remote for the oral formulations offered by Fosamax, Actonel and Boniva.
However, these oral bisphosphonate have been linked with esophageal and gastrointestinal problems, and may cause difficult or painful swallowing, severe heartburn, nausea or upset stomach, chest pain or even ulcers. Those patients who have a history of problems in the stomach or esophagus or cannot stay upright for 30 minutes after taking the medication (one hour for Boniva) are not good candidates for such medications.
Boniva Side Effects: In addition to the aforementioned symptoms, some patients taking Boniva tablets have experienced diarrhea, pain in the extremities, and mild flu-like symptoms. There is also another form of Boniva taken by injection every three months that doesn't have potential for gastrointestinal side effects or requirements for staying upright.
Read more about the side effects of Boniva.
Fosamax Side Effects: The latest research indicates a connection between Fosamax and atrial fibrillation in some patients.
Read more about the side effects of Fosamax.
Reclast Side Effects: This once-yearly infusion doesn't have gastrointestinal side effects, but patients should be aware of the possibility of dizziness, leg cramps, flu-like symptoms that last about a day, spasms or tingling with this medication. Increased incidence of atrial fibrillation has also been observed in some studies.
Evista Side Effects: This medicine - an entirely different kind of drug - has been linked to pulmonary embolisms, or blood clots in the lungs, as well as stroke. For this reason it is not recommended for anyone who might be at risk of these problems. Also, it can cause hot flashes and sweating, especially in women who have not fully completed menopause.
Read more about the side effects of Evista.
Forteo Side Effects: This drug, which is synthetic parathyroid hormone, is taken as a daily injection. Patients may experience pain, swelling or bruising at the injection site. They may also have dizziness, leg cramps, nausea, constipation and muscle weakness. This drug was found to result in increased incidence of osteosarcoma, a bone cancer, in rats, but no such cases have been reported in humans.
Read more about the side effects of Forteo.
In many cases, the established benefit of a particular drug outweighs the possible risks known to be associated with it. However, it is important your doctor is aware of your full medical history, and you should discuss thoroughly any questions or concerns you have about particular medicines and your health. And remember, never start or stop any prescription medicine without your physician's approval.
Published On: April 28, 2008