Fosamax vs Boniva

[Bonnig]

Looking for advice.!!

[HeronNS]

Don't do it!

[Bonnig in reply to HeronNS]

That's not much help

[rockyandzeus]

Hi Bonnig,

What are your circumstances? Do you have horrible T scores and osteoporosis? How much prednisone are you taking and for how long? Have you optimized your calcium and Vit D in your diet? Have you had any spinal fractures or other fractures?

Is Forteo a possibility? Expensive but rebuilds bone . So need details to be able to give advice.

Regards,

Dorothy

[Bonnig in reply to rockyandzeus]

yes, my T scores avg -2.2. At my left hip it's -2.8

I'm on 20mg..just recently diagnoses. I'm 53.

I'm taking Calcium citrate w/D3. Plus addt'l D3..50,000 IU per week to get it back to normal range. I've ener heard of Forteo.

[HeronNS in reply to Bonnig]

With those t-scores you do not need OP drugs. My t-score last year was -2 and bisphosphonates were recommended. I refused and went my way with diet, supplements and appropriate exercise and the follow up DXA scan a year later showed I'd improved to -1.6, despite being on prednisone for PMR. I will continue with my regimen for the rest of my life. The only side effects for me are improved health.

Add Vitamin K2 and make sure you have enough magnesium in your diet or through a small supplement. This will guide the calcium into your bones, which D3 alone cannot do. Weightbearing exercise and a wellbalanced diet for all the other micronutrients you need and you'll be on the road to good bone health.

[Sallyaches]

I do not recognise the drug Boniva, this may be because in the U.K. I think drugs are prescribed by their generic names not trade names. I was prescribed and am taking Risedronate once a week and so far no unpleasant side effects. I have heard of people on Fosamax having gastric problems but not everyone reacts the same way .

[sweetsusie in reply to Sallyaches]

I'm one of those people that had side effects while taking Fosamax. I couldn't swallow after 2 doses over 2 days. I'm just taking my chances now. I think all these meds. for osteoporsis are bogus. I don't understand WHY researchers can't do better for this!

[PMRpro Ambassador]

If anyone is confused: Fosamax is the brand name for alendronic acid, Boniva for ibandronate sodium.

They are both bisphosphonates but with slightly different side effect profiles, Fosamax is older and taken once a week, Boniva once a month or injected once a quarter.

This is likely to be a fairly good article comparing them although fairly superficially, there are no proper comparisons - the site is usually reliable:

healthcentral.com/osteoporo...

Fosamax has been used for longer - so it is the one that is beginning to give rise to doubts over long term use. Boniva hasn't been used for as long, only 10 compared with 15 years, so there are fewer patients on it. Boniva is licensed for low spinal bone density, Fosamax for hip and spine.

Whichever - a dexascan should have been done first to determine if they are needed at all and both calcium and vit D levels checked and put right if they are low (or high). And any major dental work likely to be needed done first before starting them.

[Bonnig in reply to PMRpro]

thanks for the article!

I also justs asked my pharmacist to print out the details of both so I can learn more!

[rockyandzeus in reply to Bonnig]

Hi Bonnig,

Not sure where you live. Have you access to an osteoporosis clinic?

Where I live you do not need a diagnosis of osteoporosis to attend the part 1 of the clinic which is a 4-5 hour education session. They cover everything you need to know to keep your bones healthy for a lifetime, including what a bone density scan is, and how to interpret the results; what foods to eat to optimize healthy bones, including how to calculate how much calcium and magnesium and vit D you get from diet and how much to supplement with ; what types of exercises are good or bad considering any fractures; and an in depth review of current meds available. I only wish I had known about it when I was in the 'osteopenia' stage.

I am 62 and I am in the 'severe osteoporosis' category now. When I was in my early 50's I had the bones 'of a young adult' according to bone mineral density scan. Then menopause, then PMR and prednisone. I tried fossamax and another bisphosphonate but they caused severe stomach problems so I relied on caltrate, extra vit D and magnesium. I thought my bones were safe!

Then last summer the fractures in spine started. I have a half dozen compression fractures in my spine, sustained without trauma. I am at very high risk for further fractures. I cannot work, cut my lawn or shovel snow (I like doing all three!). I sleep in a recliner. I can not lift up my granddaughter. My life has changed dramatically. I am trying to wean off the pred. It is not easy. I have just started Forteo, I think it may be called Forsteo in UK ( I live in Canada). It is not a bisphosphonate. It is a teriparatide, and is the only bone med that re-builds bones. It is a daily injectible that has a 24 month treatment time. My endocrinologist has said it is the drug she would take. It is listed for patients with severe osteoporosis taking corticosteroids. It is expensive and required special authorization by my drug plan. What many don't realize is that the drug company (Eli Lilly) may be able to offset the cost with special program. You have to ask and be persistent.

You are very young to have such low scores. You need those bones to last you 30 years or more. You need to make informed decisions.....they will chart your future. This is a great site to start with. I wish all the best!

Regards,

Dorothy

[Bonnig in reply to rockyandzeus]

OMG....now I'm even more scared!!! But, thank you...yes, yes, more info to make an informed decision!

[rockyandzeus in reply to Bonnig]

Oh dear, not meant to scare you. It's just that most go into PMR with good bones, and then have to deal with potential osteoporosis. You are starting with it. So, you will have to be tough (fierce like a lion) and optimize the bones while handling the PMR. I know you can do it!

[Bonnig in reply to rockyandzeus]

I just don't know what to do?! Take the Fosamax or not...I suppose I should try it and see how it goes, especially since I'm only 53 with bad bones???.

I'm taking 1000 mg Calicum Citrate every day with 1000 IU D3 plus an addt'l 42,000IU D3 every week...but I've also been on 40mg of Omeprazole every day for the last two years. I just started to cut that back to every other day.

I walk 12,000 steps most days which includes 30 minutes on an elliptical. I changed my diet to anti inflammartory except for two glasses of wine per night.

I have an appt with my Gastro guy tomorrow...hopefully he'll help me to make a final decision.

[rockyandzeus in reply to Bonnig]

why do you see a Gastro guy? Stomach problems?

[Bonnig in reply to rockyandzeus]

Yes... I have Gerd. That's why I take the Omeprazole.

Needed to see him for a check up and schedule a colonoscopy in any event. So the timing worked out with regards to asking him about Fosamax

[rockyandzeus in reply to Bonnig]

Ouch, oral bisphosphonates are very hard on esophagus.

There are injectables . Be sure to ask him about Forteo. It does not bother my tummy. Fossamax did. Good luck.

[PMRpro Ambassador in reply to Bonnig]

Bonnig - if you already have bad reflux then you need to get your gastrologist to take part in the decision too. If anyone has swallowing problems or certain degrees of reflux then Fosamax is contraindicated. As rockyandzeus says, there are forms given as injections and infusions which bypass the gastric problems.

[Bonnig in reply to PMRpro]

Thanks so much! Will discuss with Gastro today!

[PMRpro Ambassador in reply to rockyandzeus]

"most go into PMR with good bones"

That is actually an unknown factor - unless someone has already had a dexascan done or done within the first month of pred you cannot know what state their bones were in. Most patients struggle to get a dexascan done. Doctors who hand out pred panic, they don't make the same fuss over omeprazole, which is just as likely, if not more so, to cause loss of bone density.

[sweetsusie]

I have osteoporosis really bad and I tried Fosomax. After 2 doses over 2 days, I was eating a meal with my friend, and all of the sudden I was unable to swallow! That is one of the side effects. Scared me to death. So I called my doctor and she told me to stop taking it immediately. NOw I have a male doctor who wanted to do infusions with Reclast, but once I read all the side effects and somethings that the women who had had it done said, I won't do that either. So..I'm just going to take my chances! All of these meds can cause thigh bone fractures, although they say they're rare. I'm not willing to risk it. I know nothing about Boniva, but I'm assuming it has the same side effects as the others. Good luck...be careful!

[karools16 in reply to sweetsusie]

Hello sweetsusie. I also have osteoporosis and also tried Fosamax, and was also ill, so I just stopped, and didn't even tell the dr. I am now on Ibandronic Acid Mylan, 1 tablet, once a month, and NO SIDE-EFFECTS! So, you see, they don't all have bad effects.

[sweetsusie in reply to karools16]

Thanks, karools16!! I will check it out.

[sweetsusie in reply to karools16]

Hi, again, karools16. Looked up the information you gave me..this is Boniva, which is in the same class as Fosamax...so, this will not work for me.

[karools16 in reply to sweetsusie]

Pity.It worked for me.Hope you find something that does agree.

[PMRpro Ambassador in reply to sweetsusie]

The different things do have different side effects despite being the same group of substances - but Boniva is also available as an injection.

[HeronNS]

This weekend our newspaper has a notification of the over $6 million settlement Merck has agreed to in the class action suit filed on behalf of those Canadians who have experienced osteonecrosis of the jaw or atypical femur fractures after taking Fosamax and Fosavance. Merck is not admitting responsibility. However they are the manufacturers of Fosamax and Fosavance. Affected Canadians have until July to file their claim.

[Bonnig in reply to HeronNS]

Oh geez!!!!!!!!!!!!!!!!