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bisphosphonates Update by FDA
I have been on and off Fosamax for several years. As of Feb. 2026, the FDA has updated the safety labels for bisphosphonate medications to include a warning that atypical fractures can occur in bones other than the femur. These include the ulna (arm) and tibia (lower leg). The updated warning includes fosamax, reclast, actenol, Boniva. The warning is for those on bisphosphonates longer than 5 years. I just happen to come upon the update or I wouldn't have been aware of it. I'll be discussing it with my endocrinologist. There is no need to panic but knowledge is everything!
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I started alendronate once a week about 3 months ago and seem to be more uncomfortable and more joint pain than before. Is this normal? And if there are warnings about fractures while on it, is it really worth it to take this drug? I guess I really don’t understand why not just increase calcium intake to try to improve bone density.
@gracierose This website lists joint pain as a side effect of Fosamax: https://www.goodrx.com/alendronate/common-side-effects
My Dr prescribed Fosamax and I declined because I've read that, although it reduces bone breakdown it also reduces formation of new bone. Studies show bisphosphonates offer minimal benefits at fracture prevention, and isn't that the point of taking any bone drugs?
Here are a couple studies on the "absolute risk" vs benefit of bisphosphonates: https://www.amjmed.com/article/S0002-9343(24)00101-3/fulltext From that study: "When the baseline risk is low, use of relative risk alone is likely misleading. According to the review conducted by the ACP, the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture." "The benefits of treatment in older or less functional adults are less certain, as clinical trials mostly excluded adults over age 80 and residents of long-term care facilities; limited data in both subgroups does not support a fracture risk reduction. In addition, the long-term benefits of fracture risk reduction must be considered in the context of functionality and life expectancy. The time to benefit for bisphosphonates is estimated to be 1-2 years for important clinical outcomes like hip fracture and vertebral fractures."
Another study: https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm "Bottom line. Bisphosphonates offer only modest benefits in building bone and preventing fractures, and that should be considered along with the risks.”
I recently posted a discussion on the benefits of taking high doses of Vitamin K for osteoporosis. You can look for it under this support group.