alendronic Acid

[Fatsdomino]

Have been prescribed this by Rhuemy after waiting 3 1/2 years to see one. Have been down to 1/2 and 1 mg but symptoms returned. Have been on 3 mg for 12 months but Rhuemy has upped me to 5mg explaining about ardrenals and hopes this will fully wake them up. To reduced to 4mg in 8 weeks and then down to 3mg in another 8 weeks with possible being on 3mg long term. Was on the middle of some dental treatment and took 1 … 70mg tablets (weekly one) first of all pharmacist said they would ring me in a week to see how I was reacting to them which caused me to some concern( never done this before) then telling the dentist 3 days later that I was on some new med. She said she could not treat me(possible extraction for loose tooth that’s been about for 2 years) as I would need to be referred to a specialist or hospital. Had to contact my dr and ask if he thought I could have treatment if I took no more tablets. (Only took the one) He thought it would be ok as my next visit to the dentist was 3 was away, but it depended on their protocol. This has really made me scared to take this medicine and after some research made me more aware of the side effects which scared me more. Can anyone throw any light on these tablets as some feed back has really condemned them. Thanking you in advance.

[PMRpro Ambassador]

"Rhuemy has upped me to 5mg explaining about ardrenals and hopes this will fully wake them up."

Pardon????? Someone else who didn't understand the HPA axis lecture. 5mg is enough to suppress production of cortisol. The trigger for resumption of adrenal function is LOWER pred dose,, not higher. However - at least he won't force you below 3mg which seems a very much better idea.

I assume the tablets you are talking about are once weekly alendronic acid? After ONE tablet your dentist needs a clip round the ear - that isn't going to put you at risk of anything with the extraction. I took 4 at the start of pred and stopped until I had a dexascan done - the result meant I never took another, it wasn't necessary. I have had a wisdom tooth and a back molar removed, no problems at all. If she won't do it - find another.

And before you take more alendronic acid - demand a dexascan. It seems a bit late to insist on taking them now at such a low dose without proof your bone density is low. The pharmacist was being sensible - if you have any gastric or swallowing problems they can make them worse so they wanted to check that.

UK dentists do seem to sometimes make an unnecessary fuss - I've been on pred for years and also take an anticoagulant. In the UK many dentists would insist on an extraction in hospital. Here I was looked at as if I had gone nuts and my superb dentist did it with no problem.

[Fatsdomino in reply to PMRpro]

Thanks for your reply. I am going to ask for a Dexascan as I haven’t had one at all over the nearly 4 years journey. How can she (the Rhuemy) know I need AA if there is no evidence of bone loss. I have never broken a bone and have had one or two occasions where if my bones had been weak I would have broken a bone.(Walking into a large ceramic pot in the garden one). Found some old posts on site and will really need to consider whether I take these tablets. Will probably be back for advice on alternative measures. Have taken ICal-D3 since the beginning. Always follow posts. Thanks again.(Priscilla)

[PMRpro Ambassador in reply to Fatsdomino]

They make the assumption that if you are over 65 you MUST have osteoporosis. Dangerous things assumptions ...

[Fatsdomino in reply to PMRpro]

Agree. Had 1 decascan at 55 when menapause trail was on offer. Everything was well above average. Nothing since.

Thanks again.

[DorsetLady PMRGCAuk volunteer]

Adrenals - agree with PMRpro - maybe read this - and then explain to your Rheumy -

healthunlocked.com/pmrgcauk...

As for AA.. I took them for 4 years without an issue.. but adding them in now is a bit like locking the stable door after the horse has bolted... and check with a DEXA scan whether you actually need them..

..and dentist is over-reacting, especially if you've only just started them...

[MiniSpec]

I've been taking AA 70mg tablets once a week, along with 2 chewable calcium tablets with vit D3 each day, ever since I started on Pred for my PMR 12 years ago. I'm not sure if I ever even told my dentist about the AA, but if I did he didn't react, and I've had two extractions and other dental work done without any problems at all during that time.

For myself I found that one time I tried not taking the AA, my fingernails became very thin, weak and brittle, so I started taking them again and have had no further problems since. However, I know someone else with RA who is on Methotrexate and who has never taken AA, saying it didn't suit her lifestyle (?)

Anyway, she hasn't collapsed into a shapeless pile of flesh due to bones disintegrating, so I guess she doesn't need them. Meanwhile, I think your dentist is being a little alarmist by not treating you due to taking ONE AA tablet, so maybe it's time to look for another dentist?

[Fatsdomino in reply to MiniSpec]

Thank you MiniSpec for your information. Will take onboard what you have said and decide my next course of action. First step will be to get a dexascan and take it from there. Glad that we can air are concerns on this forum.