A worrying and largely unacknowledged side-effect of bisphosphonates – the chronic, often severe, joint and bone pain, swelling of ankles and feet, muscles cramping and stiffness, and difficulty walking has been reported by many women using Fosamax and Actonel. The Food and Drug Administration published correspondence in the Archives of Internal Medicine in February 2005 analysing over 100 reports of similar physical symptoms described by some consumers as ‘severe’ ‘extreme’ ‘disabling’ or ‘incapacitating’. The authors comment that the clinical trials leading to the FDA approval of Fosamax and Actonel did not identify this side-effect, but acknowledge that previously unknown side-effects can sometimes surface once a drug is out there in the market place.
This certainly seems to be the case with bisphosphonates as the list of negative effects grows ever longer. The FDA advised dentists and cancer physicians in May 2005 that the labels or package inserts for the injectable bisphosphonate drugs zoledronic acid (Zometa) and pamidronate (Aredia) had been revised to warn about the possibility of osteonecrosis of the jaw with the use of these drugs. Osteonecrosis literally means “bone death.” There have also been reports in the medical literature of osteonecrosis of the jaw associated with the use of Fosamax and Actonel.
There are concerns that Fosamax might impair bone healing and that the drug-induced increase in bone minerals could make bones more brittle. A report in The Journal of Clinical Endocrinology and Metabolism in March 2005 described nine patients on Fosamax with osteoporosis or osteopenia who had non-traumatic (low impact) fractures. Six patients continuing the drug experienced delayed or no healing of broken bones. In a New York Times article Postmenopausal Women Face Issues About Bone Loss journalist Jane Brody reports on the case of “a healthy active woman, 59, who after six years on Fosamax for osteopenia in her spine was jolted on a subway and broke her thigh bone. The injury took two years to heal, and the healing occurred only after she had stopped taking Fosamax. A year later, she resumed the drug, only to suffer a non-traumatic fracture in her foot.”
The vast majority who take Fosamax will receive no benefit. A review of the data for a range of osteoporosis treatments from eleven randomised clinical trials of at least 3 years duration failed to find any non-vertebral fracture benefit at all from Fosamax raising further questions about its widespread unchecked use.
Our challenge as healthcare consumers is to find genuinely independent information regarding disease prevention, the diagnosis of conditions, and the safest most effective methods of treatment. It can be hard to find, but is increasingly available as more doctors, journalists and individuals question the over-medicalisation of ‘worried well’ adult populations and the aggressive way the pharmaceutical industry is convincing people that drugs are preferable to time-tested simple lifestyle changes such as eating well, exercising and quitting smoking.
Your literature re osteoporisis is highly interesting. I have taken Fosamax for approximately 3 years and find that my gums are receding. My dentists (plural) and periodontist assure me that Fosamax is not the culprit. However, my teeth are healthy and so are mygums. I do not take any other medications. Have you ever heard anyone else complain about this condition with regards to Fosamax? Many thanks for reading this.
What are the side-effects of Biphosphonate when given with Remicade?
I am sorry I don’t know. I haven’t been able to find any evidence of an interaction.
I am a clinical researcher who has closely worked with and had discussions with pharmaceutical research endocrinologists. I was told well over a year ago that research has shown that although these drugs appear to increase the density of the bone many are not convinced that they actually make the bones stronger.
In addition, an older physician I spoke to suggested I take the herb horsetail as a supplement. He indicated that thinning is a natural progression of aging however ones bones should not be brittle. Horsetail contains silica and he contends that this will help the thinning bones retain elasticity. The following indicates that scientific evidence is in it’s infancy: “Silicon may be beneficial for bone strengthening. Because horsetail contains silicon, it has been suggested as a possible natural treatment for osteoporosis. Preliminary human study reports benefits, but more detailed research is needed before a firm recommendation can be made.” .
My own experience with Actonel was very severe and I actually discovered the causality between the afib and the bisphosphonate before my physician was alerted to it. My body reacted to Actonel with severe muscle cramps, atrial fibrillation and severe TMJ. I am convinced that prior to osteonecrosis occurring there are many people who are getting an early warning through the development of TMJ. I had an MRI of my mandibular and I had a 15% bone loss on the left side. I have since developed a questionnaire and am collecting data to substantiate my theory. Anyone on bisphosphonates with TMJ that appeared after starting medication and are interested in documenting their experience, can request a copy to complete and return to me.