Fosamax Is an Appropriate, Albeit Powerful Medicine for Osteopenia
DEAR DR. ROACH: I’m a 65-year-old, overweight white woman. I recently had a DEXA scan, and based on the results, my general physician prescribed Fosamax for osteopenia.
The first dose created a horrible reaction two days after ingestion, with severe pain in both of my arms, my neck, and my legs. I was in absolute agony for two days, then it cleared up. With the next dose a week later, I hesitated, but still decided to take it. Two days later, the reaction hit me again, only worse. I could barely walk, and my energy was so low. I spent four days in bed, except to cry when heading to the bathroom. I had not taken my Lasix prescription for those four days, as I could barely make it to the bathroom. I contacted my doctor, and she discontinued Fosamax. She’s referring me to a rheumatologist. I read that this drug has all my symptoms, plus more, listed under the severe reaction warning. I will not take it again. Also, a friend told me that this drug is not effective for osteoporosis after more than 20 years of drug tests, and I should not have been prescribed this drug, since I have osteopenia, not osteoporosis. Your thoughts? — C.W. ANSWER: Alendronate (Fosamax) is in the class of drugs called bisphosphonates. These are powerful drugs that should not be prescribed lightly. They do have the potential for severe side effects. Severe musculoskeletal pain can occur days or months (sometimes years) after starting the medicine. The Food and Drug Administration has advised prescribers to discuss this possibility with their patients so that the drug can be stopped immediately if it occurs. There are other options available if the person really needs treatment. Your friend is half right. Powerful drugs like Fosamax are usually not indicated in people who have low bone mass (osteopenia) without osteoporosis. However, a history of a fragility fracture (breaking a bone from minor trauma that isn’t expected to cause a fracture) can make the diagnosis of osteoporosis, even if the bone density isn’t in the usual osteoporotic range. A person can have a high risk of fractures for other reasons, and a clinical tool called the FRAX score helps clinicians identify those who might benefit from treatment. But your friend is also half wrong. When used appropriately, Fosamax and other bisphosphonate drugs are effective at reducing the risk of fractures. A vertebral body fracture can cause years of pain and be avoided easily, while a hip fracture can be devastating. So, there are very good reasons to prescribe these medicines. Finally, let me warn readers against complacence in treatment with these drugs. They may be appropriately prescribed for a high-risk person, but most people should not stay on this drug forever. Follow-up DEXA scans should guide therapy, and after three to five years, a conscious decision should be made whether to continue therapy. Readers who have been on these drugs for more than five years and haven’t had careful follow-ups on their results should ask their doctors whether they still need to be taking them. Dr. Roach regrets that he is unable to answer
individual questions, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. © 2024 North America Synd., Inc. All Rights Reserved 
Enjoying Winter Squash Now
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• When preparing outdoor furniture for winter storage, it's important to give it a nice cleaning. If you have a truck, why not load it up and bring it to the local self-serve car wash? The specialized brushes make it easy to clean right there in the back of the vehicle, and a pressure rinse gets soap and dirt from all the nooks and crannies.
• To keep algae from growing in your backyard birdbath, add a few copper pennies. Or you can get a small piece of copper pipe from the home-improvement store. It keeps the algae from getting out of control. • When you need an extra garbage bag, like during a party or while doing lawn chores, try this cool trick: Use a large pop-up laundry bin, and line it with a lawn and leaf garbage bag. Use chip clips to secure it at the top if you need to. • "We keep a regular size galvanized steel trash can with lid out on our deck for the kids' toys. It's big enough to hold everything, convenient enough to drag around the yard to clean up, and the lid protects the toys from the weather and bugs!" — W.K. in Illinois • "I had a plastic storage bin that cracked and I was about to throw it out when my son stopped me. He cut holes in either side and used it to cover the outdoor pipes that stick up out of the ground. Now they will be protected from cold temperatures, and from the weed eater through the rest of fall. My boy!" — T.R. in South Carolina • "To clean the TV remote in my home, I dip a cotton swab into rubbing alcohol, shake off any excess and use it to gently clean the surface. I do this weekly during cold and flu season." — M. in Minnesota • To keep track of rolls of tape or other rolled items in your shop, hang a length of chain from two "S" hooks on your pegboard. They will be readily accessible, and you can tear off what you need. • "If you use those little plastic key-ring cards for store rewards accounts and discount programs, you can keep them easily organized in a small photo brag book. These books can be found at drugstores and big box retailers, and are meant for a small collection of wallet-size pictures. However, if you put your cards in one, it's easy to flip through to find the correct card to scan." — R.I. in Arkansas • "Here's a fun idea for place cards at Thanksgiving (coming up in Canada): Scan in and print out a photo of each guest as a child. Laminate it and attach it to a pretty piece of ribbon with a glue gun. Use the ribbon to tie up a napkin and/or utensils. Guests will have a good time trying to guess who's who and reminiscing about days gone by." — P.D. in Ontario, Canada • When working with juicy items (lemons, watermelon, etc.) on a cutting board, try placing the board on a kitchen towel. When the juices run over the edge, they will be caught by the towel. Cleanup will be easy! Send your tips to
Now Here’s a Tip, 628 Virginia Drive, Orlando, FL 32803. © 2024 King Features Synd., Inc. 
Try This Tasty and Healthy
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