This reduced absorption allows the body to increase bone density, which in turn reduces the risk of fracture. The pills are available in 5 mg, 10mg, 35 mg, 40 mg, and 70 mg strength. The usual dosage for osteoporosis prevention is 35 mg once weekly, or 5 mg once daily.
The usual dosage for osteoporosis treatment is 70 mg once weekly, or 10 mg once daily. You doctor will tell you how many pills to take and how often. When adherence rates are as good in the community as they are in clinical trials, the effectiveness of bisphosphonates is the same as in clinical trials. Like all drugs, bisphosphonates can sometimes cause side effects. In this report we explore some possible adverse effects associated with these drugs, focusing on the parts of the body or the specific adverse effects.
Some bisphosphonates can be taken intravenously and so the digestive tract is not affected. However, among oral formulations of these drugs, instructions for taking them must be adhered to, otherwise adverse events may occur that affect the stomach. Thus, upon waking in the morning and arising from bed, the following instructions are standard:. These steps allow water to carry the pill into the stomach and intestines, where it breaks down and is absorbed.
If these instructions are not followed, the pill may lodge in the tube that connects the mouth to the stomach the esophagus or in the stomach itself, and then irritate these tissues. If that happens, the following symptoms can occur:. Temporary flu-like symptoms are more common among people who take intravenous formulations of these drugs; they rarely occur in people taking intermittent oral bisphosphonates. All of these differences between zoledronate and placebo were statistically significant.
These symptoms usually occurred within a day after the infusion and cleared in about three days in most participants. In another study, women who were deficient in vitamin D were more likely to experience these symptoms than other women.
The greater the degree of vitamin D deficiency, the greater the risk of developing APR symptoms. Doctors experienced in the use of intravenous bisphosphonates have prescribed standard doses of acetaminophen Tylenol at the time of the infusion and then for the next 72 hours as needed. This tends to minimize APR symptoms.
In , there were reports of 23 cases of esophageal cancer in the U. However, these reports cannot prove that the drugs caused this particular form of cancer. Subsequently, observational studies in the U. In the UK, researchers have amassed a large database—the General Practice Research Database GPRD —containing health-related information from about 42, people who have used bisphosphonates.
Two studies have attempted to explore the issue of exposure to bisphosphonates and cancer using this database. One study gave the impression that bisphosphonates were not significantly associated with an increased risk for esophageal cancer, while the other study gave the opposite impression.
To resolve this apparent discordance, two scientists who engage in bone research reviewed the data from the two UK studies. They noted that there have been previous cases of studies into other drugs that have arrived at seemingly different conclusions when data from the GPRD has been analysed. However, when those previous studies with other drugs were carefully re-analysed, the reasons for differing conclusions became apparent.
In re-examining the two apparently conflicting bisphosphonate studies, the researchers found that important differences about the studies emerged:. This difference in monitoring has the potential to have a huge impact on conclusions drawn by the study authors. By taking this difference in monitoring into account, the bone health experts were able to form useful conclusions about bisphosphonates. Here is what they suggested:.
After three years of use, for every 10, patients treated with bisphosphonates, there are likely to be about five additional cases of esophageal of cancer, although it is possible that there will be between five fewer and 24 additional cases of esophageal cancer. Due to the observational nature of the studies, the bone researchers cannot provide firm estimates of cancer risk, and so there is some uncertainty about the actual number of people that could develop esophageal cancer.
It is recommended that patients drink a full glass of water while taking their tablet. Pain in the Jaw. People taking Fosamax should let their doctor know if they develop sudden pain in the jaw.
Alcohol Consumption. How Fosamax Fosavance Works. Side Effects. Patients should talk to their doctor if they are concerned about any side effects. Didrocal can irritate the lining of the stomach, esophagus, or intestine. This is rare. It can result in stomach pain or trouble swallowing.
Headache — Didrocal can rarely cause a headache. People who should NOT be taking Fosamax include: Patients who are allergic to Fosamax or any ingredient in this medicine Patients who are allergic to other biphosphonate medications Patients that are pregnant or breast-feeding Anyone who becomes pregnant while taking Fosamax should notify their doctor immediately.
When to Call a Doctor. Other reasons to call a doctor while taking Fosamax include: Stomach pain or trouble swallowing Pregnant or Planning Pregnancy New severe pain in the jaw Upcoming surgery.
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