Doctors Advocate a Fosamax 'Holiday' for Their Patients

Orlando, FLThe tendency for Fosamax to cause bone fractures and Fosamax osteonecrosis is prompting many doctors to consider putting their patients on a 'drug holiday,' in order to give the body some respite against the adverse reactions inherent with bisphosphonates.

As the Orlando Sentinel reported on December 14—as did numerous publications connected to the Tribune Newspapers Syndicate—new and emerging positions on the management of osteoporosis and the relationship to bisphosphonates are suggesting that long-term use may not be a good idea.

And while it's not practical to stop them altogether, the temporary drug holiday to give the body a rest from the rigors of Fosamax side effects is an idea that has some merit, according to Dr. Richard Eastell, an expert in bone metabolism at the University of Sheffield in Britain.

When osteoporosis drugs first came out, he says, "people thought, this is a recurring disease, like high blood pressure. So why wouldn't you treat it for the rest of their lives? But there are now some anxieties with long-term use."

One of those anxieties that no one saw coming was Fosamax osteonecrosis of the jaw, or 'dead jaw' as the term is loosely described. The odd propensity for an osteoporosis drug such as Fosamax—designed to slow down bone degeneration—to actually contribute to brittle bones has impacted some people in their jawbones.

Triggered, in some cases by dental work, Fosamax ONJ is characterized by the gradual breaking down of the jaw over time, with bone loss in the jaw that affects the anchoring of teeth and other aspects of jaw use. The results can be devastating for the patient.

A question plaguing doctors, is how long should a patient remain on a bisphosphonate such as Fosamax?

"Worldwide, it's a commonly discussed question as to how long you should go on with these treatments," Eastell said. "Beyond 10 years, we have no knowledge of how these treatments work."

Some patients are approaching 10 to 15 years of continuous use.

Fosamax side effects can trigger rare and unusual fractures in the thighbone, or femur, with long-term use. A 2008 study first linked long-term use of bisphosphonates to femur fractures, and other research has confirmed the link.

Beyond the concern for Fosamax dead jaw, is a study published this past September in the British Medical Journal, which found that people who take bisphosphonate drugs for several years have a slightly higher risk of developing esophageal cancer.