Fosamax for Osteoporosis

Fosamax information for patients

Fosamax is a medication that is effective in reversing the loss of calcium from the skeleton.

When a bone density study is done, we look at the resulting T score. If the T score is minus 2 we say the patient has osteopenia which means low calcium in the skeleton.

If the T score is minus 2.5 or worse we say the patient has osteoporosis which is a more severe loss of calcium and the patient is at risk of breaking bones because they are too brittle or soft.

Loss of calcium in the bones is normal for post menopausal women. But there are factors which increase the risk.

Smoking, being thin, being white or Asian, or having a family history of osteoporosis are all risk factors.

Rheumatology patients may have an additional risk factor. The use of steroids such as Prednisone can increase the rate of loss of calcium.

If my patients take prednisone, they are all supposed to take Calcium and vitamin D. Sometimes we do a bone density test.

If the test shows a T score close to minus 2 of the hips or spine, then we say they have osteopenia and we want them to take Fosamax once every two weeks.

If the test shows a T score of minus 2.5 or worse, then we say they have osteoporosis and we would like them to take Fosamax every week 70mg.

Fosamax is an unusual drug and is very poorly absorbed. It also can hurt the esophagus. For that reason it has special rules. You are supposed to take it first thing in the morning, before coffee, juice, other medications or anything. Take it with a full glass of water, and then sit up or stand up for 40 minutes. Do not lie down.

There is a new problem I’ve come across with Fosamax. The pills are very expensive, on the order of $30 a pill.

With the new Medicare rules, we are no longer able to pay for them, and some patients have decided it’s too expensive to take at all.

What I’d suggest, until a more economical alternative comes around, is that you take at least one pill each month. This will be much less expensive than one a week, and I’m sure it’s a lot better than taking none at all.

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