DEAR DR. GOTT:
In our paper recently, you answered a letter from a reader who wanted to know if Evista was better than another drug. You replied that you were less enthusiastic about the medication and mentioned that it “should remain on the shelf” until the complications were fully understood. You mentioned that Evista can cause premature heart disease in some women.
I currently take Evista with 1200 mg of calcium. I am a healthy 53-year-old menopausal woman. Is there another drug that I should be taking in lieu of Evista? My doctor has recommended the drug (Boniva, I think), after which you have to be able to stand longer than one to two hours. I’m not thrilled with the idea of that drug either.
DEAR READER:
Every drug has side effects — even non-prescription ones. As I have mentioned before, whether a patient takes a medication or chooses not to do so, the person needs to know about the risk/benefit factors.
Biphosphonates, such as Fosamax and Boniva, do carry the rare risk of osteonecrosis of the jaw. This is increased in individuals with cancer, poor dental hygiene, and more. Evista’s possible risk of premature heart disease is some women is a far more concerning side effect.
If you have moderate to severe osteopenia (bone weakness) or any stage osteoporosis, the choice of medication is up to you and your physician. There will still be a possibility of side effects regardless of the treatment you choose. If you have mild osteopenia, you may be able to prevent worsening by increasing your daily intake of calcium and vitamin D. Speak to your gynecologist or primary care physician about possible options.
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