Minor Side effects

• Fosamax is generally well-tolerated; however, as with all drugs it does have some side effects in susceptible patients. Fortunately, because of its selective affinity for bone tissue, most of these side effects are relatively minor. These include skin rash, eye problems and generalized pain of the muscles, joints and/or bones. Fosamax users may also experience gastrointestinal problems including nausea, abdominal cramping, diarrhea, constipation and esophageal irritation. These problems may become so disagreeable to a patient that he stops taking the drug.
  
  

Esophageal Irritation

• Severe irritation of the esophagus, the tube connecting the mouth to the stomach, is a side effect of Fosamax. Signs of this problem include pain or swelling in the throat, painful swallowing and heartburn. These adverse effects are more likely at higher doses, or when the drug is taken with aspirin. To minimize potential esophageal and stomach problems, patients should take their Fosamax first thing in the morning with a full glass of water, at least 30 minutes before eating or drinking anything else. Patients should also stay in an upright position for at least 30 minutes after taking Fosamax. Adherence to this routine has greatly decreased these adverse events.
  
  

Osteonecrosis of the Jaw

• The most serious side effect linked with Fosamax to date is osteonecrosis of the jaw (ONJ), or dead jaw. Symptoms of this condition include severe jaw pain, loose teeth, gum infection, slow healing after injury or surgery involving the gums, and exposure of bone within the oral cavity. Development of ONJ in Fosamax patients is very rare; however it occurs more frequently in cancer patients after radiation therapy or chemotherapy, and in dental patients after surgical procedures.
  
  

Dental Procedures and Risk of ONJ

• Several studies have linked Fosamax with ONJ in patients following tooth extraction or other dental work. After a tooth is pulled, the bones of the jaw rebuild by filling in gaps and removing dead tissue. Fosamax may interfere with these repair processes, resulting in ONJ. Doctors and dental health care professionals need to be aware of the potential dangers of dental work in their patients on Fosamax.
  
  

Conclusion

• The burden of osteoporosis on American society is immense and continues to grow as our population ages. Fosamax and other bisphosphonate drugs have helped millions of patients to manage their disease. Furthermore, when patients and their health care providers are well informed about the drug and its appropriate dosing regimen, side effects may be minimized.