PMR, Osteoporosis and Fosamax?

Posted by slf202mcinfo @slf202mcinfo, Mar 20 3:58am

Recently diagnosed with PMR, I am now taking prednisone ( 20 mg per day). I am scheduled to begin treatment with Fosamax. Thoughts, opinions, experiences with this routine would be greatly appreciated.

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I took Fosomax from 2015 until 2018, and my osteoporosis improved to the osteopenia range. After a severe wrist fracture a year and a half ago, my primary care provider decided to restart me on it, a good decision since I was subsequently diagnosed with PMR. I absolutely feel the benefits outweigh the risks, for me at least. Most people don’t stay on it for more than three years at a time, or at least that is what I was told, since maximum bone density is achieved during that time. Not sure if that is true for people on long-term prednisone.

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Thank you for your response, exactly what my doctor said and what I am going to do.

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I have been on prednisone off and on for 20 years and now on 4 mg / day. I have had bone density tests twice in the last two years and everything was normal. My rheumatologist want to put me on Flosamax and I declined. What I haven't told you is I exercise extensively.

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@slf202mcinfo

Thank you for your reply. I have been diagnosed with osteoporosis and was on Fosamax for one year and did reasonably well with it and good bone results and then asked my doctor for a drug holiday to see if some unpleasant symptoms were related, GERD was but aches and pains were not. Then a diagnosis of PMR. My doctor definitely recommends I go back on Fosamax. Taking 20mg of prednisone for PMR. I know Fosamax definitely has risks and I don’t like taking anything but I also want to be reasonable. Osteoporosis also has big risks.

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I'd be in favor of you taking Fosamax or an equivalent. Also take Calcium with D3 and K2.

Prednisone will lead to worsening of your osteoporosis.

Taking drugs wasn't in my plans 5 months ago. When PMR jumped out and bit me, things changed. Hoping it will be short lived.

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@susanew

I took Fosamax and within a few months developed gastric ulcers and could no longer take this medication.

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I already had osteopenia before pmr.
An endocrinologist suggested Reclast, a once a year infusion. I've had 2 infusions, 2020 and 2021. My 2022 bone density improved so I decided to wait for 2024 results before any more infusions. I will be scheduling the bone density scan shortly. I agree that all the bone meds have undesirable side effects, it's a tough decision.

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FYI, there was a huge lawsuit against Merck regarding femur fractures and osteonecrosis of the jaw, yet it is still on the market! https://www.drugwatch.com/fosamax/lawsuits/

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Yes, very aware, difficult choices of risk management.

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@slf202mcinfo

Yes, very aware, difficult choices of risk management.

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Not alone is a bone density test essential but also dental x-rays. I had a problem around an implanted tooth before I went on Risedronate. When I found out how serious the situation had become I stopped taking the medication which I had been on for 6 months. I have lost a great deal of bone in that area and I will be lucky to get an implant specialist who will take my case because of the huge risk.

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I had an unusual side effect after 3 weeks of fosamax, scleritis and iritis. I woke up with throbbing pain in one eye. It is way at the bottom of the side effect list. The ophthalmologist prescribed 2 weeks of a steroid eye drop which cleared it up. However, I can’t use any of this type of medication again. I take vitamin D, mainly dietary calcium and try to be extra careful to avoid falls.

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@chickpea44

I found Fosamax difficult to take, and was switched to Risendronate … no problems with that at all. Been on it for nearly 4 years. On 10 mg of Prednisone and Methotrexate 20 mg weekly. What an ugly illness PMR is! All snakes and ladders. x

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Am also taking risendronate weekly for past 2 years with no side effects. Took prednisone for 14 months for PMR and finished September 2023.
Had flare up of PMR late January so back on Prednisone in Feb and now tapering off for the next 2 months!!!! Hopefully no more flare ups when l finish the steroids.

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