Addressing non-traumatic bone fractures

February 4, 2011 By

DEAR DR. GOTT: I have been taking Boniva for almost five years. Could I or should I stop now? I’ve heard there is some discussion about this. I’m 74. Your opinion, please.

DEAR READER: Boniva is prescribed to slow bone loss, increase bone mass, and treat or prevent osteoporosis in women, a condition in which bones become thin, weaken, and are subject to easy fracture.

The Food and Drug Administration issued a warning to physicians and their patients on Oct. 14, 2010, regarding an increased risk of bone fractures of the thigh with bone-strengthening bisphosphonates such as Boniva, Fosamax and Actonel. The report went on to indicate it remains unclear whether drugs in the category trigger thigh fractures, but because of the potential connection, labeling now warns of the possibility. [Read more...]

Filed Under: Daily Column, Leading Letter Tagged With: , , , , , , ,

Daily Column

December 11, 2008 By

DEAR DR. GOTT:
I am a Caucasian woman, 78 years old, 5’ 2 ½” tall, weight 112 pounds and am in good health. I walk every morning and ride my bike and hike whenever I can. I am not sedentary. My problem is that my bone density is not improving. I was on Fosamax for five years with no results so my doctor changed me to Boniva two years ago. There is still no improvement.

My recent bone density exam showed a T-score of negative 2.6 for the femoral neck. The previous one was negative 2.2. My T-score for L1-L4 is negative 1.2 and the one before was negative 1.1. My question to you is, what can I do to improve my bone density?

DEAR READER:
You don’t say if you are taking calcium plus vitamin D supplements. If you are not, you should be. I recommend you take 1500 mg of calcium and 400-600 IU of vitamin D daily. [Read more...]

Filed Under: Daily Column Tagged With: , , ,

Daily Column

September 23, 2008 By

DEAR DR. GOTT:
I am a 54-year-old female. One year ago I had a DEXA scan which showed severe osteopenia. I have GERD and a hiatal hernia and cannot take biphosphonate pills so my doctor put me on Boniva IV.

My question however, doesn’t have to do with the medication. Just before having the DEXA scan, I noticed several enlarged bones in my right foot and ankle. I was tested for Paget’s disease but the results were negative. At my last physical exam, my doctor noticed that my left shoulder blade had enlarged. I have seen several doctors and none can tell me what is causing my bones to enlarge. Do you have any ideas?

DEAR READER:
Because you do not say what type of testing you have had and what types of doctors you have seen I can only give you general suggestions. If these are repeats of what has been done or said, I apologize. [Read more...]

Filed Under: Daily Column Tagged With: , , , , ,

Daily Column

June 26, 2008 By

DEAR DR. GOTT:
I’m writing regarding your past column concerning the side effects of Actonel. I’ve taken Fosamax and Boniva for osteoporosis and had a terrible reaction to both. The first one put me in the hospital for five days because I was having the same symptoms as a heart attack. The Boniva that I was switched to gave me the same reaction, just not as bad. Still, it was enough to scare me. My doctor said we would never try those medications again.

DEAR READER:
As I originally reported, Actonel is ordinarily a beneficial drug. However, some people suffer side effects. Most are mild and do not justify discontinuing the drug, yet some are extremely serious. Chest and back pain, esophageal stricture, joint pain, nausea, diarrhea, back and abdominal pain, hypertension, urinary tract infections and more have been reported. As I’ve said in the past, [Read more...]

Filed Under: Daily Column Tagged With: , , ,

Daily Column

April 7, 2008 By

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.

Filed Under: Daily Column Tagged With: , , ,