Alendronic Acid

[caftan]

I have been taking AA now for 3 years and 4 months every Sunday morning. I wondered if it would matter if I miss taking it on Christmas Day. What do others think? I did have a dexa scan a few months ago and the result was low body mass. I am 82.

[HeronNS]

It shouldn't matter. In fact you should ask your doctor if you should consider a drug "holiday" as you may become at risk for "atypical" fracture caused by new bone being laid over an increasingly aging matrix as the drug stops normal bone remodelling.

I was told I had "low bone mass" which my doctor misinterpreted to mean osteoporosis. As I found out it meant what is commonly referred to as osteopenia, which is bone thinning, but not osteoporosis. Do you know your actual most recent t-score reading?

However a bone med isn't like a heart med or something which you must have daily; you should be able to safely miss a dose, even if you decide you want to continue taking it in the new year.

[caftan in reply to HeronNS]

Thank you for that. I forot to say that I am going to stay with relatives over the Christmas period, travelling today and coming back next week. I have no idea what my recent t-score reading is or what that means. I had a reply by text from my surgery following the dexa scan which said "Your dexa scan for your bone health shows that you have low bone mass. The specialists have advised that you continue taking Alendronic Acid for a total of 10 years, with a repeat scan in 3 years' time". I was quite horrified by this. I discussed it with my GP on the phone and she confirmed what the text said.

[HeronNS in reply to caftan]

If you were taking Prolia or Evenity that would be another matter. Those work in a completely different way from bisphosphanates and must never be stopped unless a bisphosphonate, or in some cases teriparatide, is substituted. A bisphosphonate stays in the bones pretty much indefinitely so what you have already taken will continue working.

I think in order to make a really informed decision you should be given your t-score. It's not a perfect measure, and there are other risk factors to consider, but you are "between 3-5 years" which is the usual recommendation nowadays, so if it were me I'd definitely be thinking about a drug holiday, if it seems safe. Have you experienced any fractures?

Have a look at my story for some ideas about other things you can do to help your bones:

healthunlocked.com/pmrgcauk...

also:

osteoporosis.ca/medical-con...

[Janstr]

I agree with Heron that you can definitely miss a dose with no issues You could take it on Boxing Day if you want, or miss it for the week. I don’t take it if not feeling well & GP is ok with that

[Kendrew]

Hi caftan,

I took Alendronic Acid for 3yrs, before taking a break from it.

During the time I was on it I had one particular week when I completely forgot to take it at all but I was completely okay and experienced no side effects as a result of doing so.

There were also a couple of times when I forgot to take it on my designated day but remembered the next day....so I just took it then instead.

When you take a 'drug holiday' from it, or come off it completely, you don't need to wean yourself off it like you do steroids....you can safely just stop taking it, so missing it one time is not going to be an issue.

[DorsetLady PMRGCAuk volunteer]

One week in 3 years isn’t going to make a difference, the effects stay in your body a long time …

Enjoy your “day off’ 😊

[SnazzyD]

The effect of the bone drugs don’t stop a day after you miss a dose, so if it were me I’d miss it for Xmas day. Everyone will have reduced bone mass when they are older, that’s normal. Whether your bone density is low enough to need bone meds is another question so your result in numbers in key here. I had thinner bones than would be liked but still didn’t need bone meds.

[PMRpro Ambassador]

You definitely won't crumble overnight!

I assume you mean low bone density not body mass? How low? What are your t-scores, do you know? After 3 years on AA, they should be better so I think maybe a re-think would be a good idea.

[caftan in reply to PMRpro]

Sorry, yes I meant to say low bone density.

[HeronNS in reply to PMRpro]

and caftan I was definitely told "low bone mass" which my GP misinterpreted as "low bone density", but the OP team also recommended bisphosphonates because of other risk factors: age, previous fracture, prednisone. I had a t-score of -2 and seven years since that recommendation I've not taken any bone meds nor, despite a stupid accident, broken anything! But, as you, PMRpro, know, I've worked hard to maintain and improve my bone density.

[PMRpro Ambassador in reply to HeronNS]

caftan said body mass ... rather different thing!!!!

[HeronNS in reply to PMRpro]

True. But I thought it could have been "bone mass" rather than "bone density" as this is in fact what I was told. Not bone density. Otherwise I wouldn't have noticed. And likewise wasn't told my t-score. And had I not been the kind of contrary person I am I could have been on AA since 2015.

[PMRpro Ambassador in reply to HeronNS]

And me since 2009 or so!

[pakien]

I was on it for 4 years ,Then had a Dextra Scan and my Bones were fine so told the Doctor I did not want to take it anymore, am sure this Medicatin caused me to get AF.

[PMRpro Ambassador in reply to pakien]

It is PMR that caused my A/F. Definitely not AA - didn't take it.

[Rugger]

I took bone meds for 5 years and am now on permanent 'holiday' from them, with my GP's blessing. Enjoy your holiday!!

[Miacaro45]

I have taken off with my doctor’s blessing and all went well. That is the beauty of taking this pill over some infused drug.