Fosamax Scare: Those With Osteopenia Gauge Risk

"They said there was a rare, but real chance that my bottom jaw would become infected and might have to be removed," said George, a 67-year-old retired college teacher from Frisco, Texas.

Drug Companies Push Bone-Loss Drugs

She said she was put on Fosamax at age 50 because her thyroid was not processing calcium properly.

"People like Sally Field are pushing Boniva, which is the same damn thing and people are listening and saying, 'Oh, I should really be on that,'" George said.

"The ads say if you are small-boned or tall or white, you may get osteoporosis, but I am all three," she said. "People think that's all there is and they don't know the other side of the story. They don't know what the side effects are."

Though the drug was linked to osteonecrosis in 2004, Merck added no warning until 2005.

"Most reported cases of osteonecrosis in bisphosphonate users have been in cancer patients treated with intravenous bisphosphonates, but cases have also been reported in patients taking oral bisphosphonates, including Fosamax," says Merck on its Web site.

In 2008, the Food and Drug Administration reached out to Merck about the reports of femur fractures. After 16 months, Merck added those patients' reports to the list of possible side effects reported by patients included in the drug's package insert.

"Nothing is more important to Merck than the safety of its medicines," said Merck in a prepared release. "As part of our commitment, Merck closely monitors post-marketing data and reports that information to FDA and other regulatory agencies."

"A causal association has not been established between long-term bishphosphonate use and low energy femoral shaft and subtrochanteric fractures," it said. "In clinical studies, Fosamax (alendronate sodium) has not been associated with increased fracture risk at any skeletal site."

The company did say that these femoral fractures had been reported in non-bisphosphonate users and is doing further investigation.

They cite statistics from the U.S. Surgeon General that show osteoporosis is a national health threat for women over 50 and increases with age.

Doctors disagree on the use of bisphosphonates for those with osteopenia. They say bisphosphonates have helped those with osteoporosis fight bone thinning, but put others with osteopenia at risk with a medication that may not necessarily help them.

McLearen, who now has full-blown osteoporosis, understands the paradox: "I know that they have to help some people, but with these drugs it's money first and I don't think they have researched it enough to give Fosamax it to all these people."

Dr. Nortin Hadler, professor of medicine and microbiology at University of North Carolina at Chapel Hill, is opposed to the treatment of osteopenia, which he says is the "the natural course of aging."

"We have a history of over treatment and over-medicalization of people in this country and we need a discussion that's out loud and up front," said Hadler, author of "Worried Sick" and "The Last Well Person."

For those who are in their 50s and "otherwise healthy," there is no reason to have a bone density test, he said.

A 50-year-old woman with osteopenia has a much lower risk of fracture within a five-year period than an 80-year-old with the same bone density.

In some cases, however, testing makes sense, especially for people prone to osteoporosis because they have taken steroids, have nutritional issues or have inflammatory bowel disease.

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