Fosamax and Osteonecrosis of the Jaw

Whitehouse Station, NJOne hundred years ago, people who manufactured matches for a living were susceptible to a horrible ailment called Phossy jaw. Caused by exposure to the white phosphorus then used in matches, Phossy jaw reduced facial bones to rotten mush. Surgical intervention was often required to remove the jawbones of workers unlucky enough to come down with this condition.

Industrial reforms eliminated Phossy jaw, but now a similar condition is starting to show up in patients who use bone-strengthening medications such as Fosamax. The condition is called Osteonecrosis of the jaw (ONJ) or "dead jaw syndrome".

When someone has ONJ, bone tissue in their jaw can no longer heal properly following even minor scrapes and bruises. ONJ can lead to infection, discomfort and severe pain. Teeth become loosened, the jaw swells and eating or drinking becomes uncomfortable tasks. As with Phossy jaw, surgery is sometimes necessary to remove dead teeth and bone.

The drug Fosamax has been cited as a possible culprit in ONJ cases. Launched in 1995, Fosamax is a member of the bisphosphonate drug family used in the treatment of osteoporosis (weakening of the bones). Bisphosphonate medications are also commonly used in some cancer treatments.

Pharmaceutical giant, Merck, makes Fosamax. Headquartered in Whitehouse Station, NJ, Merck has 60,000-employees worldwide and earned revenues of $22.6 billion last year.

Oral surgeons first began to notice a connection between ONJ and bisphosphonate drugs about five years ago. Between 2003 and 2006, doctors reported about 400 instances of ONJ in medical journals, the vast majority of which occurred in people taking bisphosphonate medications as part of a cancer therapy regime.

Fosamax isn't the only bisphoshonate drug that's been linked to ONJ, but it is one of the most commonly used medications of its type. In addition to cancer treatment, it's particularly popular in women with osteoporosis. An estimated 1.8 million women in the United States take Fosamax.

People who frequent the "Askapatient.com" [website] may also want to seek legal help: many of them have very little good to say about Fosamax. This site allows patients to rate various medications and offer opinions on their worth.

As of May 22, 2007, the site boasted 523 ratings for Fosamax. The drug received an average rating of 1.5 out of a possible 5 (with 5 being "very satisfied" and 1 being "very dissatisfied").

"Taken Fosamax for about 1½ years," reported a 56 year-old female. "For the last month and a half, noticed I cannot sleep on my right side. My jaw starts to ache to the point where I get headaches and also my whole left side was sore (felt as if it was inflamed). Also noticed extreme tiredness and exhausted feeling."

"Jaw tightening and painful—hard to open and close mouth; neck muscles, lymph nodes sore, ringing in the ears," reported a 62 year-old woman who took Fosamax for two months.

Other patients write of "severe, flu-like symptoms", extreme pain, acid reflux, tooth- aches, cramps, and other unpleasant symptoms.

Merck's website for Fosamax doesn't mention anything about ONJ or jaw rot. It does suggest that "if you develop severe bone, joint and/or muscle pain at any time, contact your doctor."

For Fosamax users who develop ONJ, contacting a lawyer might be a better idea.