DEAR DR. GOTT: I have been taking Fosamax for years to treat post menopausal bone loss. About three weeks ago my femur bone broke and I also had a benign tumor at the site of the breakage. I spent two weeks in the hospital getting that repaired. They put a steel rod in my leg and I developed severe post surgery colitis.
My question is — is Prolia a good alternative for Fosamax?
DEAR READER: Prolia (denosumab) is a monoclonal antibody designed to identify and destroy only certain body cells. It is prescribed for the treatment of osteoporosis in postmenopausal women who are at high risk of bone fracture by working to slow bone loss and increase bone strength. It should not be used if a woman has low blood calcium levels, or if she is allergic to any of the ingredients in the products. Prior to its use, a woman should speak with her prescribing physician regarding any allergies to drugs, foods or other substances; if she has a history of thyroid or pancreatic problems; if she has a compromised immune system or is taking any medication to suppress the immune system; if she is unable to take calcium or vitamin D supplements daily; if she has recently experienced a bone fracture; or is taking any over-the-counter supplements or other medications. There is always the possibility of a drug interaction.
Prolia may lower the ability to fight infection; may cause jaw bone issues in some patients; may develop an increased risk of medical problems if she is undergoing a course of chemotherapy, radiation, is on corticosteroids; or has poor dental hygiene.
Possible side effects of the medication include dry skin, back, muscle and extremity pain, and constipation.
You are faced with a difficult decision. According to my resources, your recent fracture might preclude you from considering Prolia; however, that decision would be best left to your physician. I recommend you make an appointment to go over your medical history, any medications you might be on and then weigh the odds together to determine if this drug is correct for you. I do not have access to your medical records and cannot determine if it is in your best interests or not.
While there, you might ask about the use of 1500 mg of calcium coupled with 800 IU of vitamin D daily to help build stronger bones. If you combine this with a program of daily exercise and a nutritious diet to include broccoli, nuts, shellfish, tofu, dairy products and whole grain products that aren’t made with refined flour, you just might be able to avoid the medication issue altogether. And, as you might have guessed by now, that would likely be my recommendation if you were my patient.
Readers who would like related information can order my Health Report “Osteoporosis” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order made payable to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
