Thursday, June 11, 2009 Jo asks

Q: Fossamex vs. Boniva - is there really a difference? Strength of drug?

My doc prescribed fossmex (actually the generic, Allendronate Sodium 70 MG). The first week I took it, I had a mild headache and some GI upset. Nothing major.

I took my second dose a week later and I'm so sick from the side effects. I took it Monday (followed directions appropriately) and it's now Thursday and I have GI upset. Side effects included, headache, chest pain, acid stomach, excessive gas and the most recent today is diarreah. This is the most painful heartburn I have EVER experienced.

Called my doc and the pharmacist and both suggsted I start a course of Prilosec and I've been eating rolaids and drinking malox. I'm self employed so, it's not easy to miss work (haven't missed a day in ten years). Yesterday, I could barely more.

Now, my doc wants me to start Boniva next week. I read online about it and I'm very concerned that I'm just going to have the same reaction. Side effects are GI related. Not to mention another side effect of insomina (which I already suffer from on occasion). I'm very concerned since this is a once monthly drug. If I react in the same manner, wouldn't this "poison" just be in my system longer? Suffering from GI symptoms for at least a month?

Can anyone provide any insight into this?

A couple other side notes, my doc is indicating that I need to be on the bone drugs for probably the remainder of my life. I'm 46 years old. I already do weight bearing exercise (have my whole life) and there is not much to step up in this regard. No underlying causes for my osteo and no family history. The only possible link we've found is perhaps from the drug Lupron which I took for six months to treat endometreosis (gee, no wonder why I'm apprehensive about meds??? I think they have a strong effect on me).

BTW, This fossamex (alendronate) has caused the WORST hot flashes too!

Any insight is appreciated!!!

Answers (3)

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Pam Flores

6/12/09 6:24pm

Hi Jo, welcome and thanks for your question. Lupron taken over time can cause bone loss, so if that is the cause I'm so sorry.

Is your Dr recommending the oral Boniva? If you are having terrible gi side effects from Fosamax, have you considered the injectable Boniva given 4 times a year? This option is used for those who have the gi related problems because injectable Boniva doesn't go through the intestinal tract. This med has side effects but they aren't gi related, here's a link from HealthCentral on Boniva IV.

You may want to ask about this option since you've had stomach issue with Fosamax. Some say that Boniva has less side effects, but since you've already have gi issues Boniva oral would probably cause the same thing. Look into the injectable if you think that may interest you.

Good luck and if you have any other questions post again.

6/15/09 8:30am

Thanks for the response. Yes, my dr. is recommending the oral boniva. Frankly, I was so sick from the Fosamex, that I have decided for the time being to not take any medications. My GI upset is still lingering one week later. I lost time from work. The gas pains and nausa were incredible. Trouble sleeping (had to sleep upright). The burning in my chest was the most uncomfortable thing I've ever experienced. Twice, I nearly choked after drinking milk - seemed like all the fluid was coming up from my stomach into my lungs (I think that is aspiration?). I have been taking Prilosec daily now (on my 5th day), and using Malox as needed during the day and before bed. I've had little appetite - eating lots of crackers and rice. My appetite started to come back a couple days ago. Now, everything is more lower GI (diarea) and still some mild burning in the chest and pit of my stomach. I feel like I'm starting to turn the corner and I'm starting to elminate some of the drug from my body. Wondering how much longer all these symptoms will last? Or, if my doctor should actually see me? I frightens me that my dr. wanted to start me on the oral Bonina today - only one week after the dose I took. I have not been able to speak directly with my doctor; however, have spoken with the nurse numerous times about the incident to explain what has been happening. Frustrated with that situation; however, that is a whole different discussion! Thanks for the info about the Boniva IV. It is concerning that a possible side effect is stomach upset. Again, concerning because I've had such a strong reaction with a drug from the same family. And, where this is an injectable drug, how long will it stay in your system if you have an adverse reaction? I've had two bone scans (one from part of a health study that I am in) and the other was by my health provider to confirm the results of that first scan. My T scores were - AP Spine -2.9, Lateral Spine -2.6, Femoral neck - 1.4, and hip -1.1. I am in great physical shape and have been doing weight bearing exercise nearly daily throughout my entire adult life. I'm 46 years old. Three drs. concurred that I needed meds because of the results and the fact that I already do weight bearing exercise and my calcium and D levels are fine. It only begs the question, have I've been living with these scores for years, and can I continue to live with the scores for more years? Do you think I'm making a mistake by not trying another med - at least until I get another bone scan in two years? I am frightened to experiment with these drugs (keep in mind, I'm someone who barely takes advil). I felt so bad after taking the fosmex that it felt like I was poisoned. I'm going to look into some other natural ways to help build bone. Not sure what is out there or, if there is such a thing. Not much more I can do with weight bearing exercise, I eat right, don't smoke, take my vitamins, and do all the right things. Thanks for your help!

Pam Flores

6/15/09 11:20am

Hi Jo, I can certainly see why you are leary of any of the bisphosphonates (fosamax, actonel, boniva and reclast). I hope your multiple stomach problems go away soon.

The iv dose of boniva claims it has less stomach side effects, but Roche still lists "stomach upset" as a symptom for <2% of those studied in the clinical tral.

According to Roche, the 2-4 mg dose, of iv boniva, has a half-life of 4.6 to 15.3 hours, and the 5 mg dose is 25.5 hours. The half life is the amount of time it takes for half of the drug to leave your body. The half life on the oral boniva is actaully longer at 37 to 157 hours.

Since you're having such a hard time with Fosamax have you look into Fosteum? I've never taken it, but the ingredients are: D3, zinc and genistein (form of soy). Here's an article on it in case you are interested with clinical studies on it's effectiveness.

Good luck finding something that doesn't upset your stomach.

6/15/09 3:21pm

This is excellent information! Thank you so much. I am very intriqued with the Fosteum and will do some additional research on this! Curious, I looked up the 1/2 life of fosamex and it says 10 years! This is a very potent drug. You've been so helpful. Appreciate it!

Pam Flores

6/15/09 4:37pm

Hi again, you are absolutely correct; the half life of fosamax it is 10 years. Of the bisphosphonates (fosamax, actonel, reclast, and boniva etc.) fosamax stays in the body the longest. However since you only took a couple doses, I would imagine that the accumulation in your system isn't as great as others and hopefully it won't last that long.

If you get a chance to read the article on Fosteum, notice that the clinical trial mentioned in the first or second paragraph has been moved, and I posted the new location of it in the *last comment* below the article.

Good luck and if you have any other concerns don't hesitate to post again, we are here to help!!

Pam Flores

8/13/09 12:11pm

Correction on IV Boniva Half Life:

2 mg dose ranges from 4.6 to 15.3 hours

4 mg dose ranges from 5 to 25.5 hours

See Roche for source of information: http://www.rocheusa.com/products/Boniva/Injection_PI.pdf

Joanie

6/16/10 12:33pm

Hi Jo, I would be very careful before I would take Boniva IV (or any Boniva for that matter). It would seem that any med you take that is only required every three months has its active effect stay in your body for about 3 months. So, if you have a bad experience, you may be stuck with it for a long time. And, to clear up the confusion about the half life of Boniva. The maximum plasma (blood) half life is about 6 1/2 days. So, on average, it is out of the blood in 13 days. But, its tissue half life (stay in the bone) is about 10 years by most reliable accounts. I am currently having some very odd problems (back pain, tingling in back and legs and hands, hair loss, and hip pain; previously fatigue and trouble swallowing). I have had nerve conductions tests and MRIs that do not show up anything as a direct cause for the back problem and tingling. I finally put two and two together, looked up the side effects and blogs on Boniva and have definitely decided to quit it!!!!!!!!! I hope the side effects leave, but I have been on the once monthly Boniva for 22 months. My next dose is due in three days, and I will never take it again. Good luck, but be careful with the osteoporosis meds.

6/16/10 2:37pm

Thanks for the info. I am still med-free and plan to stay that way. The more I hear about these drugs as well as drugs regularly prescribed for other problems (ie, lipitor, etc.), I think it is a huge pharmaceutial scam. Sounds like it's a good thing you stopped. Good luck to you and hope that your problems dissipate.

Joanie

6/17/10 11:03am

I need to make a clarification. The plasma half life number I gave is for the once monthly Boniva.

Question for Jo - Are the side effects gone now, one year later?

By the way, I will keep track of what I suspect are the side effects of Boniva and report back to let people know if they abate.

Joanie