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Who manufacturers Fosamax?
Fosamax is manufactured by Merck & Company.

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Are there any reported problems with Fosamax?
Cases of osteonecrosis (involving the jaw) have been reported in patients treated with bisphosphonates. The majority of the reported cases are in cancer patients who are having, or have had, a dental procedure.

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What is osteonecrosis of the jaw?
Osteonecrosis of the jaw (ONJ)is a rare condition that involves the loss, or breakdown, of the jaw bone. ONJ has been reported in patients with cancer receiving treatment, including bisphosphonates, chemotherapy, and/or corticosteroids. The majority of reported cases have been associated with dental procedures such as tooth extraction. A dental examination with appropriate preventive dentistry should be considered prior to treatment with bisphosphonates in patients with concomitant risk factors. While on treatment, these patients should avoid, if possible, invasive dental procedures. No data are available as to whether discontinuation of bisphosphonate therapy reduces the risk of ONJ in patients requiring dental procedures.

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What are the symptoms of ONJ?
Tell both your oncologist and your dentist immediately if you experience any of these symptoms: pain, swelling, or infection of the gums; loosening of teeth; poor healing of the gums, and numbness or the feeling of heaviness in the jaw.

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How is ONJ diagnosed?
To diagnose osteonecrosis of the jaw, doctors may use x-rays or tests for infection (microbial cultures). Treatments for osteonecrosis of the jaw may include antibiotics, oral rinses, and removable mouth appliances. Minor dental work may be necessary to remove injured tissue and reduce sharp edges of the bone. Surgery is typically avoided because it may make the condition worse.

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What are the risk factors for developing osteonecrosis of the jaw?
Those at risk for developing ONJ include those individuals who have:

• Taken bisphosphonates, especially in IV form
• Been involved with concurrent use of steroids
• A previous history of cancer, osteoporosis or Paget's disease
• Had a traumatic dental procedure, such as tooth extraction or dental implants.

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Who should not take Fosamax?
Patients who should not take Fosamax include those who:

• Have certain disorders of the esophagus
• Are unable to stand or sit upright for at least 30 minutes
• Have low levels of calcium in their blood
• Have severe kidney disease
• Are pregnant or nursing

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What are the potential side effects of Fosamax?
Some patients may develop severe digestive reactions including irritation, inflammation or ulceration (occasionally with bleeding) of the esophagus. These reactions can cause chest pain, heartburn or difficulty or pain upon swallowing. This may occur especially if patients do not drink a full glass of water with Fosamax and/or if they lie down in less than 30 minutes or before their first food of the day. Esophageal reactions may worsen if patients continue to take Fosamax after developing symptoms suggesting irritation of the esophagus.

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What should I do if I’m currently taking Fosamax?
The most important step for patients currently taking Fosamax is to discuss their health and history with their physician. Your doctor is hopefully aware of the potential health risks associated with bisphosphonates and may advise using an alternative in order to minimize the risk of osteonecrosis from this drug. Patients must educate themselves on the potential risks, and, if they experience any side effects, must immediately contact their doctor.

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