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Harvard Medical School
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General Medical Questions
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Question : I am a 75-year-old woman in good health. I was diagnosed with osteoporosis at age 68. I have been taking Fosamax for the past 7 years. I read that there are risks in taking these types of drugs for more than 5 years. What should I do?
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The Trusted Source
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Maria A. Yialamas, MD is an instructor of medicine at Harvard Medical School and staff endocrinologist at Brigham and Women's Hospital (BWH). She also serves as the associate program director of the BWH internal medicine residency program.

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March 14, 2011
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A:

Unfortunately, this question does not have a clear-cut answer.

Fosamax (alendronate) belongs to a class of drugs called bisphosphonates. Others in this class include:

  • Actonel (risedronate)
  • Boniva (ibandronate)
  • Reclast (zoledronic acid)

They are all very effective in treating osteoporosis.

Many studies have shown that these drugs significantly strengthen bones. These drugs also decrease the risk of spine and hip fractures. Because hip fractures are one of the leading causes of disability and death in older people, Fosamax and other bisphosphonates are needed for people at a high risk for fracture.

Over the last few years, however, there has been increasing concern that after 5 years of use these drugs could weaken bones. They can specifically increase the risk of a rare type of fracture (of the thigh bone or femur).

The decision about whether to stop using Fosamax should be made by you and your doctor. Your risk of fracture and your current bone density will influence the decision.

Many people with very severe osteoporosis or a history of fractures may need to continue Fosamax forever. Their risk of a hip or spine fracture is greater than the small risk of developing a femur fracture. For others who are at a low risk for fracture and have a stable bone mineral density scan, stopping the Fosamax may be appropriate.

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