How has taking Fosamax or its generic equivalent affected you?

Good evening, @zenalda, and welcome to Connect. I am also taking Alendronate. In fact, today I went for my first Dexa scan since I started Fosamax two years ago. I am anxious to find out the results from my endocrinologist at the Mayo Clinic.

Interestingly, you mentioned the possibility of a broken thigh bone. Would you expand that comment a bit more? Do you have information about your thigh bone problem? I am asking. because I have just had three weeks of thigh pain. The orthopedic surgeon told me that my situation was caused by bursitis.

What else are you hoping to learn about from Connect members?

May you be safe, protected, and free from inner and outer harm.
Chris

It's true that atypical femur fracture can occur with Fosamax/alendronate, although it is rare. The risk increases the longer you have been on the drug, so a "drug holiday" might be recommended after 3-5 years for some patients, depending on their fracture risk level. Some people stay on it longer, with 10 being the upper limit. I have been on alendronate for almost 4 years with no side effects of any kind. I am switching to a bone-building anabolic in the coming months. Although my scores were stable with alendronate, which is sort of a win, I still have severe osteoporosis in my spine and am hoping to improve it with an anabolic like Forteo or Evenity.

I meant to include this link in my previous post. It talks about the length of treatment and drug holidays. In sum, because there are a few serious side effects, as rare as they may be, whose risk increases the longer the drug is taken, risks may outweigh benefits for people at lower risk of fracture, so drug holidays may be recommended.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707342/

How does one know the level of one's risk for bone fractures? Is there a test for this level of risk or does one just take a chance by following medical advice and see what happens?

see reply above the word reply

By your T-scores (obtained through a Dexa scan) and previous fracture history, primarily. Family history would be another.

From the article I linked:
Low risk of fracture: treatment is not needed. If a bisphosphonate has been prescribed, it should be discontinued and not restarted unless/until the patient meets treatment guidelines. Example: 54-year-old woman, menopause at age 51, lowest T-score –1.5, no risk factors, bisphosphonate therapy for 3 years. Treatment was not indicated in the first place and can be discontinued.

Mild risk of fracture: treat with bisphosphonate for 3–5 years, then stop. The ‘drug holiday’ can be continued until there is significant loss of BMD (i.e. more than the least significant change as determined by the testing center) or the patient has a fracture, whichever comes first. Example: 68-year-old woman, menopause at age 50, initial lowest T-score –2.3, parent with a hip fracture, bisphosphonate treatment for 5 years, BMD stable over that time. Treatment was indicated, but a drug holiday might be considered after 5 years of treatment.

Moderate risk of fracture: treat with bisphosphonate for 5–10 years, offer a ‘drug holiday’ of 3–5 years or until there is significant loss of BMD or the patient has a fracture, whichever comes first. Example: 72-year-old woman, menopause at age 48, lowest initial T-score –2.8, no risk factors, bisphosphonate therapy for 7 years, BMD increased over that time so lowest T-score now is –2.3. Treatment was indicated but after 7 years of treatment, a drug holiday might be considered.

High risk of fracture (fractures, corticosteroid therapy, very low BMD): treat with bisphosphonate for 10 years, offer a ‘drug holiday’ of 1–2 years, until there is significant loss of BMD or the patient has a fracture, whichever comes first. A nonbisphosphonate treatment (e.g. raloxifene or teriparatide) may be offered during the ‘holiday’ from the bisphosphonate. Example: 75-year-old woman, menopause at age 45, lowest initial T-score –3.6, rheumatoid arthritis requiring ongoing corticosteroid therapy for 12 years, two vertebral fractures by vertebral fracture assessment (VFA), treatment with bisphosphonate therapy for 10 years. Treatment was indicated and she remains at high risk of fracture after 10 years. If a holiday from the bisphosphonate is considered, interval treatment with teriparatide or raloxifene would be prudent.

Hello Chris,
I am sure that the side effect of alendronate, " unusual fracture" of thigh bone is mentioned on many medical websites. I was also prescribed this medicine, and it was really hurting to know about this side effect ( along with jaw necrosis). But I think it happens very rarely: 46 fractures in 10000 in 10 years. Look at the article below:
https://www.bmj.com/content/353/bmj.i3365#:~:text=We%20observed%20only%2046%20subtrochanteric,for%20comorbid%20conditions%20and%20comedications.

One looks at these stats differently when one knows one of the 46. A shorter course for her would have prevented broken bones in 2 legs with the surgeries and insertion of rods.

I see. This is different.