It is estimated that about 30 million people in North America take one of the class of drugs known as bisphosphonates. These include:
- Fosamax
- Actonel
- Boniva
- Didronel
- Didrocal
- Zometa
- Aredia
- and several others
Esophagitis and Gastrointestinal Bleeding
One undisputed fact is that Fosamax can cause esophagitis and gastrointestinal bleeding. Conceivably, in a patient with severe esophagitis, as in a condition known as Barrett’s esophagus, the use of Fosamax could make the problem worse. Gastrointestinal bleeding and resulting anemia due to mucosal lining erosions caused by Fosamax are definitely possible.
The bisphosphonates are in the same class of chemical compounds used to remove soap scum from your bathtub. Most soap contains bisphosphonates to prevent ring around the bathtub. They remove soap scum by basically dissolving dead skin cells that collect on the tub after taking a bath. If a substance is strong enough to dissolve skin cells, just imagine what it can do to your stomach when you swallow it. It is for this very same reason that the pharmacist will tell you not to lie down after taking any bisphosphonate. If you do, it’s possible that the drug will erode the lining of your esophagus, stomach, or duodenum.
Bone, Joint, and Muscle Pain
Bisphosphonates have been linked to severe and incapacitating bone, joint, and muscle pain. In 2008, the FDA warned doctors that this is a possible source of intractable pain for many people using the drugs and may necessitate the use of dangerous analgesics.
When people who suffer from this side effect stop using the bisphosphonates, the pain usually subsides. These are therefore drugs that should never be given to people suffering from any form of arthritis or fibromyalgia.
Irregular Heartbeat
The April 2008 edition of the Archives of Internal Medicine published a study that found that a patient taking Fosamax had an 86% greater risk of developing an irregular heartbeat (atrial fibrillation).
Jaw Problems
Fosamax and all bisphosphonates have also been linked to an increased incidence of osteonecrosis of the jaw (the death of the jaw bone and subsequent disintegration of the jaw). Dentists are often puzzled (although they shouldn’t be) when their patients on one of the bisphosphonates develops rotting and loose teeth.
Estimates of osteonecrosis of the jaw vary from 1 to 10% of all patients using the bisphosphonates. Some dentists have stopped treating patients taking the drug for fear of further complications.
The drug remains in the bone for years after stopping it, so it is unknown how long the risk of osteonecrosis of the jaw persists. There is no known cure for the condition and it is likely that lawyers will be enriched as a result of this debilitating side effect.
Eye Problems
The bisphosphonates may also cause serious eye inflammation leading to blurred vision, vision loss, or blindness if left untreated. This side effect was first reported in the March 20, 2003 edition of the New England Journal of Medicine.
Lawsuits
Google Fosamax and you are bound to come up with at least a dozen legal web sites inviting those who have been prescribed the drug to join lawsuits against both the drug companies that manufacture the bisphosphonates as well as the doctors who prescribe the drugs.
Drug maker Merck has set aside $48 million to defend itself against lawsuits from patients harmed by Fosamax. The same company spent $500 million on lawsuits in 2006 with the drug Vioxx. It’s only a matter of time before the bisphosphonates are removed from the market—but not before the drug manufacturers have made a few billion dollars on them.
How Do These Drugs Work?
The bisphosphonates basically poison the osteoclast cells in your bone. These are the cells responsible for getting rid of old, dead, or weak bone cells.
The osteoclasts are in balance with the osteoblasts that make new bone cells. Since the osteoclasts are killed off, old and sick bone cells are allowed to somehow survive, and this is what causes the bones to look denser on x-rays.
What the bisphosphonates do, in essence, is to create a skeleton of old, dying, decayed, or sick cells. This type of bone looks denser on x-rays but is weaker and potentially hazardous to your health.
Leg Fractures
People who have been taking the bisphosphonates for over five years have increasingly been reporting a type of rare leg fracture that shears straight across the upper thighbone after little or no trauma. That’s not exactly something you would expect with a higher bone mineral density report.
Yes, the bisphosphonates make the bones look denser on the x-rays, but they also make them weaker and more brittle.
The typical history is unexplained leg pain after walking or standing for an extended period of time and an x-ray showing a fractured femur. The simple action of getting out of a car has been reported to cause the fracture.
The study was reported in the July issue of the Journal of Orthopedic Trauma on 20 patients who developed the bizarre thigh fracture after being on bisphosphonates for an average of 6.9 years. In 2007, the Journal of Bone and Joint Surgery reported that 13 women with low trauma leg fractures had been on long-term Fosamax therapy.
In my next blog, I will discuss alternatives to the bisphonates: natural ways to prevent and treat osteoporosis.
OTHER REFERENCES:
http://www.nytimes.com/2008/07/15/health/15well.html?_r=4&partner=rssnyt&emc=rss&oref=slogin
http://abcnews.go.com/Health/CancerPreventionAndTreatment/story?id=6555040&page=1
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