Thursday, March 11, 2010

Break a Leg in the Fosamax Show

Ouch. It would be pretty ironic if the drug you took religiously to strengthen your bones actually caused them to break, wouldn’t it?

Unfortunately, that may be the case for some people taking Merck’s osteoporosis drug Fosamax. There’s been an upswing in women suffering atypical breaks in the femur—the thighbone is normally a pretty strong bone—after several years of taking the drug; some of the women had merely been walking when their leg suddenly snapped. This unusual type of fracture is slow to heal and can lead to disability.

The FDA started looking into the issue in 2008 but has thus far found no conclusive link. However, a small study at Columbia University College of Physicians and Surgeons found that after four to five years, gains in the “buckling ratio” begin to reverse.

The study, by Melvin Rosenwasser, MD and a medical student, Anthony Ding, looked at 61 postmenopausal women with osteoporosis who had been taking oral bisphosphonates for at least four years and 50 controls who were taking calcium and vitamin D alone.

Other physicians speculate that long-term use of the drug may actually cause brittle bone disease; or that the bone growth driven by oral bisphosphonates like Fosamax is simply not as strong as natural bone.

Merck is currently being sued by some 900 Fosamax-users who have suffered jawbone deterioration apparently due to use of the drug.

Your takeaway: if you’re taking osteoporosis drugs of any kind, be cautious about using them for longer than a few years, be sure that you’re truly in an ‘at risk’ group rather than taking a drug your doctor just routinely prescribes, and discuss any concerns with your doctor.

And as always, report any side-effects or concerns about medications on’s systematic survey, and email the results to your physician for a more productive office visit.


  1. I've been on it for 6 years. I think it's time to quit. Thanks for the info.

  2. The 2010 AAOS meeting presented studies from the Hospital for Special Surgery (HSS) and Columbia University Medical Center showing that Fosamax disturbs bone formation, and implicated Fosamax in spontaneous mid-femur fractures (without trauma).

    Clarita Odvina MD reported nine cases of spontaneous femur fracture on Fosamax. Dr. Goh, a doctor in Singapore, identified nine more cases in his 2007 report of subtrochanteric femur fractures with minimal trauma in women on long term Fosamax. Joseph M Lane MD reported 15 cases of spontaneous femur fracture in women on Fosamax with a unique radiographic pattern. How many more case reports do we need?

    Perhaps we should re-evaluate a drug that causes spontaneous mid femur fractures, jaw necrosis, and diffuse bone and joint pain. The FIT study, published in JAMA in 1998, was a double blind placebo controlled study which failed to reveal these adverse side effects, indicating a flawed drug approval process. The bone histology slides show these drugs disturb bone physiology, creating pathological and weakened bone. The bone histology slides don't lie.

    for more see: Fosamax Fractures

    jeffrey dach md

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