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Bisphosphonate drugs, such as Merck & Co's Fosamax drug, are commonly used to treat millions of Americans with osteoporosis and other bone conditions. Like all drugs that are sold in the United States, Fosamax has FDA approval and has been clinically proven to provide benefits to patients. However, like many drugs, Fosamax and other bisphosphonates are not without risks. In order to understand those risks, it is important to understand how bisphosphonate drugs work.
The Problem of Osteoporosis
Bisphosphonates, such as Fosamax, are most commonly prescribed to patients with thinning bone densities, whose bones have become brittle and, who are at risk for bone fractures. Normal bones continually go through a period of regrowth or remodeling where the old bone is replaced by the new bone. Osteoclast cells break down bone and osteoblast cells rebuild the bone. In patients with osteoporosis the osteoclast and osteoblast cells may not be appropriately balanced which leads to weak bones that are likely to break or fracture.
How Bisphosphonate Drugs Can Help Osteoporosis Patients
Bisphosphonate drugs target bone cells by inhibiting osteoclast cells and promoting osteoblast cells in the bone. The effect is an increase in bone density that can help alleviate the problems associated with osteoporosis.
Patients who take Fosamax, take one dose a week, on the same day each week. They must take the medication before they have anything to eat or drink for the day and the must refrain from eating, drinking or laying down for 30 minutes after they have taken the medication.
Patients remain on Fosamax for different lengths of time. The length of time should be determined by the patient's doctor who carefully monitors the patient's bone density. Many patients are on Fosamax for more than one year.
What Happens When Bisphosphonates are Too Effective
While it is the goal of bisphosphonate drug therapy to increase a patient's bone density, it is possible to have too much of a good thing. If a patient's bones get too dense, the patient may no longer have the problem of osteoporosis to contend with, but other serious problems can develop.
When bones become overly dense, the appropriate amount of bone marrow may not be able to develop. Bone marrow is necessary for allowing the proper amount of blood to reach the bone. If the blood supply to the bone is interrupted then the bone may suffer from a condition called osteonecrosis, or death of the bone.
The Journal of the American Dental Association has published a study that links the use of bisphosphonate drugs with osteonecrosis of the jaw, or dead jaw bone disease. The study indicates that about 4% of patients who take Fosamax developed osteonecrosis of the jaw in the study conducted at the University of Southern California School of Dentistry.
So, while Fosamax has proven benefits for osteoporosis patients, it is not without risks. The best way to protect against the potential development of osteonecrosis and other complications is to make sure that your doctor is carefully monitoring your bone density and to make sure that your dentist is aware that you are taking a bisphosphonate drug.