Controversy arises over Bisphonate Drug Fosamax: Could it be responsible for increased bone breakage?

Women are frustrated and angry that taking Fosamax, a bisphosphonate drug which was supposed to help prevent fractures and keep their bones stronger, may actually have the opposite effect. Some doctors such as Dr. Kenneth Ego, professor of orthopedic surgery at NYU Lagone Medical Center, one of the top New York Hospitals, says that the X-Rays of some patients resemble those of a car accident victim, "We are seeing people just walking, walking down the steps…. that you could mistake for a person involved in a car accident." In many cases women who had taken Fosamax for an extended period of time had the large bones in their body like their femur which is the thigh bone, "just snap". According to Dr. Ego this is "very unusual, the fremur is one of the strongest bones in the body." The Food and Drug Administration has not yet sent out any warnings or information to doctors about the drug but says it is looking into the situation. fractured-femur

For patients like Joanna Y, a woman in her 50’s who  had breast cancer several years ago and was treated at a Texas Hospital, there are increasing challenges. Her cancer is now in remission but after getting a bone density scan, which showed the beginning stages of osteoporosis, her oncologist wanted to put her immediately on Boniva, which is another type of bisphosphonate drug, also used in the treatment of osteoporosis. What was perplexing to Joanna, is that the oncologist never brought up Vitamin D and Calcium as a first stage approach towards improving her bone density, but wanted to go immediately to a prescription product and prescribed Boniva. Joanna took the prescription for the medication but never had it filled. Because later that night she went home to research the medication and then called the oncologists office the next morning and asked if he wouldn’t consider having her try a combination of Calcium and Vitamin D3 supplements, first, before using the prescription Boniva. The oncologist agreed and then conceded that it would probably be a good idea to test Joanna’s Vitamin D3, level, because these levels were shown in some studies to be important not only in bone health in combination with Calcium, but in prevention of breast cancers. Joanna’s message to patients, "Always research any medication that your doctor prescribes, don’t just assume that he/she has checked other options, and ask lots of questions."

It is always wise to weigh the benefits versus the risks of taking any type of prescription medication. But patients many times are not aware that drug studies done on some medications and published in well respected medical journals are often times funded by the drug manufacturer. Furthermore, physicians often times receive their education about a particular medication from the sales person, otherwise known as the pharmaceutical sales representative from the pharmaceutical companies. And busy doctors, handling more patients for less reimbursement dollars, often find themselves between a rock and hard place. Trying to come up with options for patients wanting solutions for problems, yet having little time themselves to research alternatives or come up with options for patients other than prescribing pharmaceuticals for their patients. Factor in that doctors aren’t reimbursed for common over the counter products like Vitamin D and Calcium, which taken together have been shown to reduce the risk of bone fractures in both men and women of any age, and it may be easier to understand why practitioners may be quick on the draw with the prescription pad, and why patients may want to ask more questions and do more research on their own so that they can ask their physician about non-prescriptive options for certain conditions where the risks of a drug may outweigh the benefits.

Sales for bisphonate medications in 2008 were more than $3.5 billion dollars, and over 37 million osteoporosis medication prescriptions were written for osteoporosis medications.